Teaching about Haiti.

ERIC Educational Resources Information Center

Sunshine, Catherine A.; Menkart, Deborah

Developed for secondary students to place political situations in context, this document uses essays, interviews, songs, literature, and prose to present the culture of Haiti and the history of colonialism, neo-colonialism, and struggles for independence. After a historical overview, a chronology provides key dates in Haitian history. Maps of…

Malaria elimination in Haiti by the year 2020: an achievable goal?

PubMed

Boncy, Paul Jacques; Adrien, Paul; Lemoine, Jean Frantz; Existe, Alexandre; Henry, Patricia Jean; Raccurt, Christian; Brasseur, Philippe; Fenelon, Natael; Dame, John B; Okech, Bernard A; Kaljee, Linda; Baxa, Dwayne; Prieur, Eric; El Badry, Maha A; Tagliamonte, Massimiliano S; Mulligan, Connie J; Carter, Tamar E; Beau de Rochars, V Madsen; Lutz, Chelsea; Parke, Dana M; Zervos, Marcus J

2015-06-05

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d'Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on "Elimination Strategies for Malaria in Haiti" on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of

The Increase of Imported Malaria Acquired in Haiti among US Travelers in 2010

PubMed Central

Agarwal, Aarti; McMorrow, Meredith; Arguin, Paul M.

2012-01-01

From 2004 to 2009, the number of malaria cases reported in Haiti increased nearly fivefold. The effect of the 2010 earthquake and its aftermath on malaria transmission in Haiti is not known. Imported malaria cases in the United States acquired in Haiti tripled from 2009 to 2010, likely reflecting both the increased number of travelers arriving from Haiti and the increased risk of acquiring malaria infection in Haiti. The demographics of travelers and the proportion of severe cases are similar to those statistics reported in previous years. Non-adherence to malaria chemoprophylaxis remains a nearly universal modifiable risk factor among these cases. PMID:22232442

Hurricane Matthew Hits Haiti

NASA Image and Video Library

2017-12-08

Read more from: go.nasa.gov/2duxEeZ On October 4, 2016, Hurricane Matthew made landfall on southwestern Haiti as a category-4 storm—the strongest storm to hit the Caribbean nation in more than 50 years. Just hours after landfall, the Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Terra satellite acquired this natural-color image. At the time, Matthew had top sustained winds of about 230 kilometers (145 miles) per hour. Earlier on October 4, temperature data collected by MODIS on NASA’s Aqua satellite revealed that the cloud tops around Matthew were very cold (at least -57° Celsius, or -70° Fahrenheit). Cold cloud tops are known to produce heavy rainfall. The National Hurricane Center called for 380 to 500 millimeters (15 to 20 inches) of rain in Southern Haiti and in the southwestern Dominican Republic. The northward movement of the storm should bring the center of Matthew over eastern Cuba late on October 4. Dangerous conditions can extend far beyond a storm’s center. According to National Hurricane Center forecasters, Matthew is “likely to produce devastating impacts from storm surge, extreme winds, heavy rains, flash floods, and/or mudslides in portions of the watch and warning areas in Haiti, Cuba, and the Bahamas.” NASA Earth Observatory image by Joshua Stevens, using MODIS data from the Land Atmosphere Near real-time Capability for EOS (LANCE). Caption by Kathryn Hansen.

Reflections from Haiti

ERIC Educational Resources Information Center

Joseph, Carole Berotte; Jenkins-Scott, Jackie

2010-01-01

On Oct. 25 and 26, the authors took part in an unprecedented convening of higher education leaders in Port-au-Prince, Haiti. Led by the University of Massachusetts Boston, representatives from 40 colleges and universities from across the U.S., Canada, Europe, and the Caribbean gathered with representatives from the Haitian Higher Education…

Haiti, insecurity, and the politics of asylum.

PubMed

James, Erica Caple

2011-09-01

In this article, I seek to show how states of insecurity provoked by ongoing social, economic, and political ruptures in Haiti can disorder individual subjectivity and generate the flight of individuals seeking asylum within and across borders. Nongovernmental actors working in Haiti and with Haitians in the diaspora frequently managed the long-term psychosocial effects of insecurity. Their interventions can range from repressive to compassionate and influence the formation of identity and the embodied experiences of trauma for vulnerable Haitians. The case of a young Haitian refugee who was repatriated to Haiti from the United States in the 1990s demonstrates how insecurity is both an existential state reflecting the disordering of embodied experience, as well as a collective sociopolitical condition the effects of which cannot be managed or contained within national borders. The case is emblematic of the plight of thousands of Haitians affected by the January 12, 2010, earthquake.

Active Astronomy Roadshow Haiti

NASA Astrophysics Data System (ADS)

Laycock, Silas; Oram, Kathleen; Alabre, Dayana; Douyon, Ralph; UMass Lowell Haiti Development Studies Center

2016-01-01

College-age Haitian students working with advisors and volunteers from UMass Lowell in 2015 developed and tested an activity-based K-8 curriculum in astronomy, space, and earth science. Our partner school is located in Les Cayes, Haiti a city where only 65% of children attend school, and only half of those will complete 6th grade. Astronomy provides an accessible and non-intimidating entry into science, and activity-based learning contrasts with the predominant traditional teaching techniques in use in Haiti, to reach and inspire a different cohort of learners. Teachers are predominantly women in Haiti, so part of the effort involves connecting them with scientists, engineers and teacher peers in the US. As a developing nation, it is vital for Haitian (as for all) children to grow up viewing women as leaders in science. Meanwhile in the US, few are aware of the reality of getting an education in a 3rd world nation (i.e. most of the world), so we also joined with teachers in Massachusetts to give US school children a peek at what daily life is like for their peers living in our vibrant but impoverished neighbor. Our Haitian partners are committed to helping their sister-schools with curriculum and educator workshops, so that the overall quality of education can rise, and not be limited to the very few schools with access to resources. We will describe the activites, motivation, and and the lessons learned from our first year of the project.

Water, Sanitation and Hygiene in Haiti: Past, Present, and Future

PubMed Central

Gelting, Richard; Bliss, Katherine; Patrick, Molly; Lockhart, Gabriella; Handzel, Thomas

2013-01-01

Haiti has the lowest rates of access to improved water and sanitation infrastructure in the western hemisphere. This situation was likely exacerbated by the earthquake in 2010 and also contributed to the rapid spread of the cholera epidemic that started later that same year. This report examines the history of the water, sanitation, and hygiene (WASH) sector in Haiti, considering some factors that have influenced WASH conditions in the country. We then discuss the situation sine the earthquake and subsequent cholera epidemic, and the responses to those events. Finally, drawing on Haiti's National Plan of Action for the Elimination of Cholera in Haiti 2013–2022, we suggest some actions that could help bring about long-term WASH improvements for the future. Because the current WASH situation has evolved over decades of limited attention and resources, it will take a long-term, sustained effort to improve the situation. PMID:24106193

The need for dialysis in Haiti: dream or reality?

PubMed

Exantus, Judith; Desrosiers, Florence; Ternier, Alexandra; Métayer, Audie; Abel, Gérard; Buteau, Jean-Hénold

2015-01-01

According to the World Health Organization reports, nowadays burden of chronic kidney diseases (CKD) is well documented. The high prevalence of noncommunicable diseases (NCD) such as hypertension, diabetes, and obesity, which are the main causes of CKD, is a big concern in the world health scenario. These NCD can progress slowly to end-stage renal disease (ESRD) and the low-middle income countries (LMIC) like Haiti are not left unscathed by this worldwide scourge. Several well-known public health issues prevalent in Haiti such as acute diarrheal infections, malaria, tuberculosis, cholera, and acquired immunodeficiency syndrome (AIDS), can also impair the function of the kidney. Dialysis, a form of renal replacement therapy (RRT), represents a life-saving therapy for all patients affected with impaired kidney. In Haiti, few patients have access to health insurance or disability financial support. Considering that seventy-two percent (72%) of Haitians live with less than USD 2 per day, survival with CKD can be quite stressful for them. Data on the weight of the dialysis and its management are scarce. Addressing the need for dialysis in Haiti is an important component in decision-making and planning processes in the health sector. This paper is intended to bring forth discussion on the use of this type of renal replacement therapy in Haiti: the past, the present, and the challenges it presents. We will also make some recommendations in order to manage this serious problem. © 2015 S. Karger AG, Basel.

Teaching about Haiti

ERIC Educational Resources Information Center

Sokolower, Jody

2010-01-01

For a few harrowing weeks in January, the eyes of the world were on Haiti, struggling with the impact of a 7.0 magnitude earthquake. In the spotlight's glare, people saw the devastation wrought by the natural disaster. Viewers with a critical eye or access to alternative media also saw a U.S. military presence more focused on security than food…

Cholera management and prevention at Hôpital Albert Schweitzer, Haiti.

PubMed

Ernst, Silvia; Weinrobe, Carolyn; Bien-Aime, Charbel; Rawson, Ian

2011-11-01

In October 2010, Hopital Albert Schweitzer Haiti treated some of the first patients with cholera in Haiti. Over the following 10 months, a strategic plan was developed and implemented to improve the management of cases at the hospital level and to address the underlying risk factors at the community level.

Health Outcomes for Children in Haiti Since the 2010 Earthquake: A Systematic Review.

PubMed

Dube, Annie; Moffatt, Madeline; Davison, Colleen; Bartels, Susan

2018-02-01

Haiti remains the poorest country in the Americas and one of the poorest in the world. Children in Haiti face many health concerns, some of which were exacerbated by the 2010 earthquake. This systematic review summarizes published research conducted since the 2010 earthquake, focusing on health outcomes for children in Haiti, including physical, psychological, and socioeconomic well-being. A literature search was conducted identifying articles published from January 2010 through May 2016 related to pediatric health outcomes in Haiti. Two reviewers screened articles independently. Included research articles described at least one physical health, psychological health, or socioeconomic outcome among children less than 18 years of age in Haiti since the January 2010 earthquake. Fifty-eight full-length research articles were reviewed, covering infectious diseases (non-cholera [N=12] and cholera [N=7]), nutrition (N=11), traumatic injuries (N=11), mental health (N=9), anemia (N=4), abuse and violence (N=5), and other topics (N=3). Many children were injured in the 2010 earthquake, and care of their injuries is described in the literature. Infectious diseases were a significant cause of morbidity and mortality among children following the earthquake, with cholera being one of the most important etiologies. The literature also revealed that large numbers of children in Haiti have significant symptoms of posttraumatic stress disorder (PTSD), peri-traumatic stress, depression, and anxiety, and that food insecurity and malnutrition continue to be important issues. Future health programs in Haiti should focus on provision of clean water, sanitation, and other measures to prevent infectious diseases. Mental health programming and services for children also appear to be greatly needed, and food insecurity/malnutrition must be addressed if children are to lead healthy, productive lives. Given the burden of injury after the 2010 earthquake, further research on long

IMPROVED COOK STOVES FOR HAITI USING THERMOELECTRICS TO REDUCE DEFORESTATION AND IMPROVE QUALITY OF LIFE

EPA Science Inventory

Haiti, the poorest country in the Western Hemisphere, is plagued with continual problems due to severe deforestation throughout the country. Haiti was once nearly completely covered by lush forest, but now less than three percent of Haiti is forested. This environmental cala...

Life and Literacy in Haiti: A Conversation with Jocelyne Trouillot

ERIC Educational Resources Information Center

Lehman, Barbara A.; Logan, Cheryl L.

2011-01-01

A year after the earthquake that devastated Haiti in January 2010, Lehman and Logan have a virtual conversation with Jocelyne Trouillot, author and publisher of Haitian Creole children's books, founder of the Haiti section of the International Board on Books for Young People, and head of the Universite Caraibe in Port-au-Prince. They discuss the…

Saving Children, Saving Haiti? Child Vulnerability and Narratives of the Nation

ERIC Educational Resources Information Center

Hoffman, Diane M

2012-01-01

Long before the earthquake in Haiti on 12 January 2010, but particularly since, international media and humanitarian groups have drawn attention to the "vulnerable child" in Haiti, a child often portrayed as needing "saving". Focusing in particular on the "restavek" (child domestic laborer), this article first…

The cost of antiretroviral therapy in Haiti

PubMed Central

Koenig, Serena P; Riviere, Cynthia; Leger, Paul; Severe, Patrice; Atwood, Sidney; Fitzgerald, Daniel W; Pape, Jean W; Schackman, Bruce R

2008-01-01

Background We determined direct medical costs, overhead costs, societal costs, and personnel requirements for the provision of antiretroviral therapy (ART) to patients with AIDS in Haiti. Methods We examined data from 218 treatment-naïve adults who were consecutively initiated on ART at the GHESKIO Center in Port-au-Prince, Haiti between December 23, 2003 and May 20, 2004 and calculated costs and personnel requirements for the first year of ART. Results The mean total cost of treatment per patient was $US 982 including $US 846 in direct costs, $US 114 for overhead, and $US 22 for societal costs. The direct cost per patient included generic ART medications $US 355, lab tests $US 130, nutrition $US 117, hospitalizations $US 62, pre-ART evaluation $US 58, labor $US 51, non-ART medications $US 39, outside referrals $US 31, and telephone cards for patient retention $US 3. Higher treatment costs were associated with hospitalization, change in ART regimen, TB treatment, and survival for one year. We estimate that 1.5 doctors and 2.5 nurses are required to treat 1000 patients in the first year after initiating ART. Conclusion Initial ART treatment in Haiti costs approximately $US 1,000 per patient per year. With generic first-line antiretroviral drugs, only 36% of the cost is for medications. Patients who change regimens are significantly more expensive to treat, highlighting the need for less-expensive second-line drugs. There may be sufficient health care personnel to treat all HIV-infected patients in urban areas of Haiti, but not in rural areas. New models of HIV care are needed for rural areas using assistant medical officers and community health workers. PMID:18275615

The Haiti House Project

ERIC Educational Resources Information Center

Ayers, Ann; McMillan, Ellen; McMillan, Liberty

2010-01-01

On January 12, 2010, a catastrophic earthquake hit the small country of Haiti, reducing buildings and homes to piles of rubble and killing thousands of people. Immediately, the people of the United States and of just about every country in the world began to devise ways to help the victims of this tragedy. After seeing a presentation that showed…

Area Handbook Series: Dominican Republic and Haiti: Country Studies

DTIC Science & Technology

1991-01-01

Sierra de Baoruco and are intermittent, flowing only after heavy rainfall. The Lago En- riquillo itself covers some 265 square kilometers. Its water...only three-Marc Bazin’s Move- ment for the Installation of Democracy in Haiti (Mouvement pour l’Instauration de la Democratie en Haiti-MIDH), Serge...established over the powers of the rural section chiefs (chefs de section), so that the rural population could vote in an atmosphere free of coercion and

Cholera in Haiti: Reproductive numbers and vaccination coverage estimates

NASA Astrophysics Data System (ADS)

Mukandavire, Zindoga; Smith, David L.; Morris, J. Glenn, Jr.

2013-01-01

Cholera reappeared in Haiti in October, 2010 after decades of absence. Cases were first detected in Artibonite region and in the ensuing months the disease spread to every department in the country. The rate of increase in the number of cases at the start of epidemics provides valuable information about the basic reproductive number (). Quantitative analysis of such data gives useful information for planning and evaluating disease control interventions, including vaccination. Using a mathematical model, we fitted data on the cumulative number of reported hospitalized cholera cases in Haiti. varied by department, ranging from 1.06 to 2.63. At a national level, 46% vaccination coverage would result in an () <1, which would suppress transmission. In the current debate on the use of cholera vaccines in endemic and non-endemic regions, our results suggest that moderate cholera vaccine coverage would be an important element of disease control in Haiti.

[Culture and mental health in Haiti : a literature review].

PubMed

Pierre, Andrena; Minn, Pierre; Sterlin, Carlo; Annoual, Pascale C; Jaimes, Annie; Raphaël, Frantz; Raikhel, Eugene; Whitley, Rob; Rousseau, Cécile; Kirmayer, Laurence J

2010-01-01

This paper reviews and summarizes the available literature on Haitian mental health and mental health services. This review was conducted in light of the Haitian earthquake in January 2010. We searched Medline, Google Scholar and other available databases to gather scholarly literature relevant to mental health in Haiti. This was supplemented by consultation of key books and grey literature relevant to Haiti. The first part of the review describes historical, economic, sociological and anthropological factors essential to a basic understanding of Haiti and its people. This includes discussion of demography, family structure, Haitian economics and religion. The second part of the review focuses on mental health and mental health services. This includes a review of factors such as basic epidemiology of mental illness, common beliefs about mental illness, explanatory models, idioms of distress, help-seeking behavior, configuration of mental health services and the relationship between religion and mental health.

Cholera Vaccination in Urban Haiti

PubMed Central

Rouzier, Vanessa; Severe, Karine; Juste, Marc Antoine Jean; Peck, Mireille; Perodin, Christian; Severe, Patrice; Deschamps, Marie Marcelle; Verdier, Rose Irene; Prince, Sabine; Francois, Jeannot; Cadet, Jean Ronald; Guillaume, Florence D.; Wright, Peter F.; Pape, Jean W.

2013-01-01

Successful and sustained efforts have been made to curtail the major cholera epidemic that occurred in Haiti in 2010 with the promotion of hygiene and sanitation measures, training of health personnel and establishment of treatment centers nationwide. Oral cholera vaccine (OCV) was introduced by the Haitian Ministry of Health as a pilot project in urban and rural areas. This paper reports the successful OCV pilot project led by GHESKIO Centers in the urban slums of Port-au-Prince where 52,357 persons received dose 1 and 90.8% received dose 2; estimated coverage of the at-risk community was 75%. This pilot study demonstrated the effort, community mobilization, and organizational capacity necessary to achieve these results in a challenging setting. The OCV intervention paved the way for the recent launching of a national cholera vaccination program integrated in a long-term ambitious and comprehensive plan to address Haiti's critical need in water security and sanitation. PMID:24106194

Genetic Diversity of Plasmodium falciparum in Haiti: Insights from Microsatellite Markers

PubMed Central

Carter, Tamar E.; Malloy, Halley; Existe, Alexandre; Memnon, Gladys; St. Victor, Yves; Okech, Bernard A.; Mulligan, Connie J.

2015-01-01

Hispaniola, comprising Haiti and the Dominican Republic, has been identified as a candidate for malaria elimination. However, incomplete surveillance data in Haiti hamper efforts to assess the impact of ongoing malaria control interventions. Characteristics of the genetic diversity of Plasmodium falciparum populations can be used to assess parasite transmission, which is information vital to evaluating malaria elimination efforts. Here we characterize the genetic diversity of P. falciparum samples collected from patients at seven sites in Haiti using 12 microsatellite markers previously employed in population genetic analyses of global P. falciparum populations. We measured multiplicity of infections, level of genetic diversity, degree of population geographic substructure, and linkage disequilibrium (defined as non-random association of alleles from different loci). For low transmission populations like Haiti, we expect to see few multiple infections, low levels of genetic diversity, high degree of population structure, and high linkage disequilibrium. In Haiti, we found low levels of multiple infections (12.9%), moderate to high levels of genetic diversity (mean number of alleles per locus = 4.9, heterozygosity = 0.61), low levels of population structure (highest pairwise Fst = 0.09 and no clustering in principal components analysis), and moderate linkage disequilibrium (ISA = 0.05, P<0.0001). In addition, population bottleneck analysis revealed no evidence for a reduction in the P. falciparum population size in Haiti. We conclude that the high level of genetic diversity and lack of evidence for a population bottleneck may suggest that Haiti’s P. falciparum population has been stable and discuss the implications of our results for understanding the impact of malaria control interventions. We also discuss the relevance of parasite population history and other host and vector factors when assessing transmission intensity from genetic diversity data. PMID:26462203

Haiti. A Study of the Educational System of Haiti and a Guide to the Academic Placement of Students in Educational Institutions of the United States. World Education Series.

ERIC Educational Resources Information Center

Simmons, Ruth J.

The educational system of Haiti is described, and guidelines for placement of Haitian students in U.S. schools at the secondary and postsecondary levels are presented. An introductory section covers Haiti's history, government, language, religion, school organization and administration, public and private education, and recent reforms. In addition…

Imaging the crustal structure of Haiti's transpressional fault system using seismicity and tomography

NASA Astrophysics Data System (ADS)

Possee, D.; Keir, D.; Harmon, N.; Rychert, C.; Rolandone, F.; Leroy, S. D.; Stuart, G. W.; Calais, E.; Boisson, D.; Ulysse, S. M. J.; Guerrier, K.; Momplaisir, R.; Prepetit, C.

2017-12-01

Oblique convergence of the Caribbean and North American plates has partitioned strain across an extensive transpressional fault system that bisects Haiti. Most recently the 2010, MW7.0 earthquake ruptured multiple thrust faults in southern Haiti. However, while the rupture mechanism has been well studied, how these faults are segmented and link to deformation across the plate boundary is still debated. Understanding the link between strain accumulation and faulting in Haiti is also key to future modelling of seismic hazards. To assess seismic activity and fault structures we used data from 31 broadband seismic stations deployed on Haiti for 16-months. Local earthquakes were recorded and hypocentre locations determined using a 1D velocity model. A high-quality subset of the data was then inverted using travel-time tomography for relocated hypocentres and 2D images of Vp and Vp/Vs crustal structure. Earthquake locations reveal two clusters of seismic activity, the first delineates faults associated with the 2010 earthquake and the second shows activity 100km further east along a thrust fault north of Lake Enriquillo (Dominican Republic). The velocity models show large variations in seismic properties across the plate boundary; shallow low-velocity zones with a 5-8% decrease in Vp and high Vp/Vs ratios of 1.85-1.95 correspond to sedimentary basins that form the low-lying terrain on Haiti. We also image a region with a 4-5% decrease in Vp and an increased Vp/Vs ratio of 1.80-1.85 dipping south to a depth of 20km beneath southern Haiti. This feature matches the location of a major thrust fault and suggests a substantial damage zone around this fault. Beneath northern Haiti a transition to lower Vp/Vs values of 1.70-1.75 reflects a compositional change from mafic facies such as the Caribbean large igneous province in the south, to arc magmatic facies associated with the Greater Antilles arc in the north. Our seismic images are consistent with the fault system across

Wòch nan Soley: the denial of the right to water in Haiti.

PubMed

Varma, Monika Kalra; Satterthwaite, Margaret L; Klasing, Amanda M; Shoranick, Tammy; Jean, Jude; Barry, Donna; Fawzi, Mary C Smith; McKeever, James; Lyon, Evan

2008-01-01

This article combines health and water research results, evidence from confidential documents released under the Freedom of Information Act, legal analysis, and discussion of historical context to demonstrate that actions taken by the international community through the Inter-American Development Bank are directly related to a lack of access to clean water in Haiti. The article demonstrates that these actions constitute a clear violation of Haitians' right to water under both domestic and international law. The article exposes the United States governments role in blocking the disbursal of millions of dollars in international bank loans that would have had life-saving consequences for the Haitian people. The loans were derailed in 2001 by politically-motivated interventions on behalf of the US and other members of the international community in direct violation of the Inter-American Development Bank charter. To demonstrate the impact of these interventions, the article presents data gathered in a study that employed human rights and public health methodologies to assess the right to water in Haiti. The data reveal that Haitians experience obstacles concerning every aspect of the right to water: diffculties with water availability, limited physical and economic accessibility, and poor water quality. The article provides a framework of concrete duties and obligations that should be followed by all actors involved in Haiti in order to realize Haitians' human right to water. In response to the undeniable link between the international community's political interference and the intolerably poor state of potable water in Haiti, the article concludes with a recommendation that all actors in Haiti follow a rights-based approach to the development and implementation of water projects in Haiti. The full report of Wòch nan Soley: The Denial of the Right to Water in Haiti is available online at http://www.pih.org/inforesources/Reports/Hait_Report_FINAL.pdf.

Integrating oral health into Haiti's National Health Plan: from disaster relief to sustainable development.

PubMed

Estupiñán-Day, Saskia; Lafontant, Christina; Acuña, Maria Cecilia

2011-11-01

In 2010, Haiti suffered three devastating national emergencies: a 7.0 magnitude earthquake that killed over 200 000 and injured 300 000; a cholera outbreak that challenged recovery efforts and caused more deaths; and Hurricane Tomas, which brought additional destruction. In the aftermath, the Pan American Health Organization (PAHO) reoriented its technical cooperation to face the myriad of new challenges and needs. Efforts included support and technical assistance to the Ministry of Health and Population of Haiti and coordination of actions by the United Nations Health Cluster. This Special Report focuses specifically on the PAHO Regional Oral Health Program's call to action in Haiti and the institutional partnerships that were developed to leverage resources for oral health during this critical time and beyond. To date, achievements include working with Haiti's private sector, dental schools, public health associations, and other stakeholders, via the Oral Health of Haiti (OHOH) Coalition. The OHOH aims to meet the immediate needs of the dental community and to rebuild the oral health component of the health system; to provide dental materials and supplies to oral health sites in affected areas; and to ensure that the "Basic Package of Health Services" includes specific interventions for oral health care and services. The experience in Haiti serves as a reminder to the international community of how important linking immediate/short-term disaster-response to mid- and longterm strategies is to building a health system that provides timely access to health services, including oral health. Haiti's humanitarian crisis became an important time to rethink the country's health system and services in terms of the right to health and the concepts of citizenship, solidarity, and sustainable development.

Interannual and intra-annual variability of rainfall in Haiti (1905-2005)

NASA Astrophysics Data System (ADS)

Moron, Vincent; Frelat, Romain; Jean-Jeune, Pierre Karly; Gaucherel, Cédric

2015-08-01

The interannual variability of annual and monthly rainfall in Haiti is examined from a database of 78 rain gauges in 1905-2005. The spatial coherence of annual rainfall is rather low, which is partly due to Haiti's rugged landscape, complex shoreline, and surrounding warm waters (mean sea surface temperatures >27 °C from May to December). The interannual variation of monthly rainfall is mostly shaped by the intensity of the low-level winds across the Caribbean Sea, leading to a drier- (or wetter-) than-average rainy season associated with easterly (or westerly) anomalies, increasing (or decreasing) winds. The varying speed of low-level easterlies across the Caribbean basin may reflect at least four different processes during the year: (1) an anomalous trough/ridge over the western edge of the Azores high from December to February, peaking in January; (2) a zonal pressure gradient between Eastern Pacific and the tropical Northern Atlantic from May/June to September, with a peak in August (i.e. lower-than-average rainfall in Haiti is associated with positive sea level pressure anomalies over the tropical North Atlantic and negative sea level pressure anomalies over the Eastern Pacific); (3) a local ocean-atmosphere coupling between the speed of the Caribbean Low Level Jet and the meridional sea surface temperature (SST) gradient across the Caribbean basin (i.e. colder-than-average SST in the southern Caribbean sea is associated with increased easterlies and below-average rainfall in Haiti). This coupling is triggered when the warmest Caribbean waters move northward toward the Gulf of Mexico; (4) in October/November, a drier- (or wetter-) than-usual rainy season is related to an almost closed anticyclonic (or cyclonic) anomaly located ENE of Haiti on the SW edge of the Azores high. This suggests a main control of the interannual variations of rainfall by intensity, track and/or recurrence of tropical depressions traveling northeast of Haiti. During this period, the

Lessons Learned Preparing Volunteer Midwives for Service in Haiti: After the Earthquake.

PubMed

Floyd, Barbara O'Malley

2013-01-01

Midwives for Haiti is an organization that focuses on the education and training of skilled birth attendants in Haiti, a country with a high rate of maternal and infant mortality and where only 26% of births are attended by skilled health workers. Following the 2010 earthquake, Midwives for Haiti received requests to expand services and numerous professional midwives answered the call to volunteer. This author was one of those volunteers. The purpose of the study was: 1) to develop a description of the program's strengths and its deficits in order to determine if there was a need to improve the preparation of volunteers prior to service and 2) to make recommendations aimed at strengthening the volunteers' contributions to the education of Haiti and auxiliary midwives. Three distinct but closely related questionnaires were developed to survey Haitian students, staff midwives, and volunteers who served with Midwives for Haiti. Questions were designed to elicit information about how well the volunteers were prepared for their experience, the effectiveness of translation services, and suggestions for improving the preparation of volunteers and strengthening the education program. Analysis of the surveys of volunteers, staff, midwives, and the Haitian students generated several common themes. The 3 groups agreed that the volunteers made an effective contribution to the program of education and that the volunteer midwives need more preparation prior to serving in Haiti. The 3 groups also agreed on the need for better translators and recommended more structure to the education program. The results of this study are significant to international health care organizations that use volunteer health care professionals to provide services. The results support a growing body of knowledge that international health aid organizations may use to strengthen the preparation, support, and effectiveness of volunteer health providers.

Geographic distribution of blood collections in Haiti before and after the 2010 earthquake.

PubMed

Bjork, A; Jean Baptiste, A E; Noel, E; Jean Charles, N P D; Polo, E; Pitman, J P

2017-05-01

The January 2010 Haiti earthquake destroyed the National Blood Transfusion Center and reduced monthly national blood collections by > 46%. Efforts to rapidly scale-up blood collections outside of the earthquake-affected region were investigated. Blood collection data for 2004-2014 from Haiti's 10 administrative departments were grouped into four regions: Northern, Central, Port-au-Prince and Southern. Analyses compared regional collection totals during the study period. Collections in Port-au-Prince accounted for 52% of Haiti's blood supply in 2009, but fell 96% in February 2010. Haiti subsequently increased blood collections in the North, Central and Southern regions to compensate. By May 2010, national blood collections were only 10·9% lower than in May 2009, with 70% of collections coming from outside of Port-au-Prince. By 2013 national collections (27 478 units) had surpassed 2009 levels by 30%, and Port-au-Prince collections had recovered (from 11 074 units in 2009 to 11 670 units in 2013). Haiti's National Blood Safety Program managed a rapid expansion of collections outside of Port-au-Prince following the earthquake. Annual collections exceeded pre-earthquake levels by 2012 and continued rising annually. Increased regional collections provided a greater share of the national blood supply, reducing dependence on Port-au-Prince for collections.

The experience of violence against children in domestic servitude in Haiti: Results from the Violence Against Children Survey, Haiti 2012.

PubMed

Gilbert, Leah; Reza, Avid; Mercy, James; Lea, Veronica; Lee, Juliette; Xu, Likang; Marcelin, Louis Herns; Hast, Marisa; Vertefeuille, John; Domercant, Jean Wysler

2018-02-01

There have been estimates that over 150,000 Haitian children are living in servitude. Child domestic servants who perform unpaid labor are referred to as "restavèks." Restavèks are often stigmatized, prohibited from attending school, and isolated from family placing them at higher risk for experiencing violence. In the absence of national data on the experiences of restavèks in Haiti, the study objective was to describe the sociodemographic characteristics of restavèks in Haiti and to assess their experiences of violence in childhood. The Violence Against Children Survey was a nationally representative, cross-sectional household survey of 13-24year olds (n=2916) conducted May-June 2012 in Haiti. A stratified three-stage cluster design was used to sample households and camps containing persons displaced by the 2010 earthquake. Respondents were interviewed to assess lifetime prevalence of physical, emotional, and sexual violence occurring before age 18. Chi-squared tests were used to assess the association between having been a restavèk and experiencing violence in childhood. In this study 17.4% of females and 12.2% of males reported having been restavèks before age 18. Restavèks were more likely to have worked in childhood, have never attended school, and to have come from a household that did not have enough money for food in childhood. Females who had been restavèks in childhood had higher odds of reporting childhood physical (OR 2.04 [1.40-2.97]); emotional (OR 2.41 [1.80-3.23]); and sexual violence (OR 1.86 [95% CI 1.34-2.58]) compared to females who had never been restavèks. Similarly, males who had ever been restavèks in childhood had significantly increased odds of emotional violence (OR 3.06 [1.99-4.70]) and sexual violence (OR 1.85 [1.12-3.07]) compared to males who had never been restavèks, but there was no difference in childhood physical violence. This study demonstrates that child domestic servants in Haiti experience higher rates of

Impact of DOTS expansion on tuberculosis related outcomes and costs in Haiti.

PubMed

Jacquet, Vary; Morose, Willy; Schwartzman, Kevin; Oxlade, Olivia; Barr, Graham; Grimard, Franque; Menzies, Dick

2006-08-15

Implementation of the World Health Organization's DOTS strategy (Directly Observed Treatment Short-course therapy) can result in significant reduction in tuberculosis incidence. We estimated potential costs and benefits of DOTS expansion in Haiti from the government, and societal perspectives. Using decision analysis incorporating multiple Markov processes (Markov modelling), we compared expected tuberculosis morbidity, mortality and costs in Haiti with DOTS expansion to reach all of the country, and achieve WHO benchmarks, or if the current situation did not change. Probabilities of tuberculosis related outcomes were derived from the published literature. Government health expenditures, patient and family costs were measured in direct surveys in Haiti and expressed in 2003 US$. Starting in 2003, DOTS expansion in Haiti is anticipated to cost $4.2 million and result in 63,080 fewer tuberculosis cases, 53,120 fewer tuberculosis deaths, and net societal savings of $131 million, over 20 years. Current government spending for tuberculosis is high, relative to the per capita income, and would be only slightly lower with DOTS. Societal savings would begin within 4 years, and would be substantial in all scenarios considered, including higher HIV seroprevalence or drug resistance, unchanged incidence following DOTS expansion, or doubling of initial and ongoing costs for DOTS expansion. A modest investment for DOTS expansion in Haiti would provide considerable humanitarian benefit by reducing tuberculosis-related morbidity, mortality and costs for patients and their families. These benefits, together with projected minimal Haitian government savings, argue strongly for donor support for DOTS expansion.

Mobile clinics in Haiti, part 2: Lessons learned through service.

PubMed

Haley, Janice M; Cone, Pamela H

2016-11-01

Learning from experience is a positive approach when preparing for mobile clinic service in a developing country. Mobile clinics provide healthcare services to people in hard to reach areas around the world, but preparation for their use needs to be done in collaboration with local leaders and healthcare providers. For over 16 years, Azusa Pacific University School of Nursing has sponsored mobile clinics to rural northern Haiti with the aim to provide culturally sensitive healthcare in collaboration with Haitian leaders. Past Haiti mobile clinic experiences have informed the APU-SON approach on best practices in study abroad, service-learning, and mission trips providing healthcare services. Hopefully, lessons learned from these experiences with mobile clinic service-learning opportunities in Haiti will benefit others who seek to plan study abroad service-learning trips for students in healthcare majors who desire to serve the underserved around the world. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adequate Funding for Primary Education in the Artibonite Department of Haiti

NASA Astrophysics Data System (ADS)

Nylund, Clayton Carl

Since its formation following a slave revolution in 1804, the Republic of Haiti has a long history of political instability, civil unrest and poverty. As of 2015, Haiti's gross domestic product (GDP) was US1,732, per capita, making it the poorest country in the Western Hemisphere. Haiti's education sector was no exception to this sparsity, receiving only 2.5 percent of the nation's overall GDP. The purpose of this study was to determine adequate funding for Haitian primary schools based upon mathematical achievement levels and the professional judgment of site-based administrators. A Florida Comprehensive Assessment Test (FCAT), originally administered to Florida's third-grade students in 2006, was utilized to determine mathematical achievement. In 2015, the translated FCAT was administered to 207 students, enrolled in four schools, located in the lower Artibonite department of Haiti. The results indicated that the sample answered sixteen of the forty mathematics questions correctly, on average. Based on these results, the four site-based administrators recommended the funding amounts necessary to increase mathematical achievement by 15 percent. The average annual amounts, in US dollars, included 461 per teacher salary, a 540 administrative salary, 40 per student for instructional materials, 367 per student for meals, and 37 per student for uniforms.

In Haiti, a Rare Leg Up

ERIC Educational Resources Information Center

Campbell, Monica

2007-01-01

This article features Haitian Education & Leadership Program, Haiti's largest university-scholarship program, which provides merit scholarships to students in the top 10 percent of their high-school classes in the country's poorest areas. On average, the scholarships pay students $4,100, which covers tuition, textbooks, and school supplies,…

On the probability of extinction of the Haiti cholera epidemic

NASA Astrophysics Data System (ADS)

Bertuzzo, Enrico; Finger, Flavio; Mari, Lorenzo; Gatto, Marino; Rinaldo, Andrea

2014-05-01

Nearly 3 years after its appearance in Haiti, cholera has already exacted more than 8,200 deaths and 670,000 reported cases and it is feared to become endemic. However, no clear evidence of a stable environmental reservoir of pathogenic Vibrio cholerae, the infective agent of the disease, has emerged so far, suggesting that the transmission cycle of the disease is being maintained by bacteria freshly shed by infected individuals. Thus in principle cholera could possibly be eradicated from Haiti. Here, we develop a framework for the estimation of the probability of extinction of the epidemic based on current epidemiological dynamics and health-care practice. Cholera spreading is modelled by an individual-based spatially-explicit stochastic model that accounts for the dynamics of susceptible, infected and recovered individuals hosted in different local communities connected through hydrologic and human mobility networks. Our results indicate that the probability that the epidemic goes extinct before the end of 2016 is of the order of 1%. This low probability of extinction highlights the need for more targeted and effective interventions to possibly stop cholera in Haiti.

Seeking Information after the 2010 Haiti Earthquake: A Case Study in Mass-Fatality Management

ERIC Educational Resources Information Center

Gupta, Kailash

2013-01-01

The 2010 earthquake in Haiti, which killed an estimated 316,000 people, offered many lessons in mass-fatality management (MFM). The dissertation defined MFM in seeking information and in recovery, preservation, identification, and disposition of human remains. Specifically, it examined how mass fatalities were managed in Haiti, how affected…

Stories from Haiti: a comparison of three approaches.

PubMed

Baumann, Steven L; Bellefleur, Carmelle

2014-04-01

Two stories from Haiti are considered from three different perspectives. The first story is about a boy named Joseph Alvyns, whose mother died from cholera in 2011. His story is told in a short film titled Baseball in the time of Cholera. The second story is about Mme. Yolande Marie Nazaire, who was the Director of the Haiti National School of Nursing in Port-au-Prince on the morning of January 12, 2010, when an earthquake killed 90 students and faculty. The three perspectives discussed here are: (a) Critical Reflective in health professional education as used by the University of California at San Francisco (UCSF) School of Medicine; (b) The Capacities of Stories, which is part of a socio-narratology methodology; and(c) Story Theory with implications for global health nursing.

The “First” Case of Cholera in Haiti: Lessons for Global Health

PubMed Central

Ivers, Louise C.; Walton, David A.

2012-01-01

Cholera is an acute watery diarrheal disease caused by infection with Vibrio cholerae. The disease has a high fatality rate when untreated and outbreaks of cholera have been increasing globally in the past decade, most recently in Haiti. We present the case of a 28-year-old Haitian male with a history of severe untreated mental health disorder that developed acute fatal watery diarrhea in mid-October 2010 in central Haiti after drinking from the local river. We believe he is the first or among the first cases of cholera in Haiti during the current epidemic. By reviewing his case, we extracted lessons for global health on the importance of mental health for overall health, the globalization of diseases in small communities, and the importance of a comprehensive approach to the health of communities when planning services in resource-poor settings. PMID:22232448

An Editor's Journey: Return to Haiti

ERIC Educational Resources Information Center

Moy, Yvette

2012-01-01

This paper recounts the author's story as she returned to Haiti in February to join a building project near Port-Au-Prince and to document efforts by U.S. higher education institutions to help the country rebound from the devastating 2010 earthquake. The author describes how consortiums have been formed in order to support the development of the…

Dog-Mediated Human Rabies Death, Haiti, 2016.

PubMed

Wallace, Ryan M; Etheart, Melissa D; Doty, Jeff; Monroe, Ben; Crowdis, Kelly; Augustin, Pierre Dilius; Blanton, Jesse; Fenelon, Natael

2016-11-01

Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting.

Dog-Mediated Human Rabies Death, Haiti, 2016

PubMed Central

Etheart, Melissa D.; Doty, Jeff; Monroe, Ben; Crowdis, Kelly; Augustin, Pierre Dilius; Blanton, Jesse; Fenelon, Natael

2016-01-01

Haiti has experienced numerous barriers to rabies control over the past decades and is one of the remaining Western Hemisphere countries to report dog-mediated human rabies deaths. We describe the circumstances surrounding a reported human rabies death in 2016 as well as barriers to treatment and surveillance reporting. PMID:27767911

Haiti's food and drinking water: a review of toxicological health risks.

PubMed

Schwartzbord, J R; Emmanuel, E; Brown, D L

2013-11-01

The Republic of Haiti is a developing country in the Caribbean region with a history that challenges toxicologists, yet the historical panoply of toxicological hazards in Haiti has received little scholarly attention. The primary objectives of this paper are to review what is known about Haiti's current toxicological hazards, with a focus on chronic food-borne aflatoxin exposure and heavy metal contamination of water resources, and to compare these with previous large-scale, acute exposures to toxic substances: the 1995-1996 diethylene glycol (DEG) intoxications and the 2000-2001 ackee fruit poisonings. MEDLINE/PUBMED and the library website of Cornell University were searched using the terms "Haiti" and either "heavy metals," "aflatoxin", "diethylene glycol", or "ackee". The search was inclusive of articles from 1950 to 2012, and 15 out of the 37 returned were peer-reviewed articles offering original data or comprehensive discussion. One peer-reviewed article in press, two newspaper articles, two personal communications, and one book chapter from the personal databases of the authors were also referenced, making a total of 21 citations. Elevated concentrations of aflatoxins (greater than 20 μg/kg) were documented for staples of the Haitian food supply, most notably peanut butters and maize. Human exposure to aflatoxin was confirmed with analysis of aflatoxin blood biomarkers. The implications of aflatoxin exposure were reviewed in the light of Haiti's age-adjusted liver cancer risk - the highest in the Caribbean region. Measurement of heavy metals in Port-au-Prince ground water showed contamination of lead and chromium in excess of the US Environmental Protection Agency's 15 μg/L Action Level for lead and 100 μg/L Maximum Contamination Level Goal for total chromium. The DEG contamination of paracetamol (acetaminophen) containing products in 1995-1996 claimed the lives of 109 children and the 2000-2001 epidemic of ackee fruit poisoning resulted in 60 cases of

An imperial laboratory: the investigation and treatment of treponematoses in occupied Haiti, 1915-1934.

PubMed

Stewart, Antony Dalziel McNeil

2017-01-01

This article examines anti-treponematoses work as part of US occupation public health policy in Haiti, a unique event in the history of international health. Yaws was highly prevalent in Haiti, but occupation doctors initially ignored it because of its close association with syphilis and stigmas attached to sexually transmitted disease. This changed when C.S. Butler asserted that yaws was "innocent" and that the two diseases should therefore be considered as one. Treatment increased as an anti-treponematoses campaign was now believed to hold great benefits for the occupation's paternalist and strategic aims, even though it ultimately failed. This work reflected Haiti's status as a public health "laboratory" which affected Haitian medicine for years to come and significantly influenced future campaigns aimed at disease eradication.

A Cluster of Dengue Cases in American Missionaries Returning from Haiti, 2010

PubMed Central

Sharp, Tyler M.; Pillai, Parvathy; Hunsperger, Elizabeth; Santiago, Gilberto A.; Anderson, Teresa; Vap, Trina; Collinson, Jeremy; Buss, Bryan F.; Safranek, Thomas J.; Sotir, Mark J.; Jentes, Emily S.; Munoz-Jordan, Jorge L.; Arguello, D. Fermin

2012-01-01

Dengue is an acute febrile illness caused by four mosquito-borne dengue viruses (DENV-1 to -4) that are endemic throughout the tropics. After returning from a 1-week missionary trip to Haiti in October of 2010, 5 of 28 (18%) travelers were hospitalized for dengue-like illness. All travelers were invited to submit serum specimens and complete questionnaires on pre-travel preparations, mosquito avoidance practices, and activities during travel. DENV infection was confirmed in seven (25%) travelers, including all travelers that were hospitalized. Viral sequencing revealed closest homology to a 2007 DENV-1 isolate from the Dominican Republic. Although most (88%) travelers had a pre-travel healthcare visit, only one-quarter knew that dengue is a risk in Haiti, and one-quarter regularly used insect repellent. This report confirms recent DENV transmission in Haiti. Travelers to DENV-endemic areas should receive dengue education during pre-travel health consultations, follow mosquito avoidance recommendations, and seek medical care for febrile illness during or after travel. PMID:22232444

Cost Evaluation of a Government-Conducted Oral Cholera Vaccination Campaign-Haiti, 2013.

PubMed

Routh, Janell A; Sreenivasan, Nandini; Adhikari, Bishwa B; Andrecy, Lesly L; Bernateau, Margarette; Abimbola, Taiwo; Njau, Joseph; Jackson, Ernsley; Juin, Stanley; Francois, Jeannot; Tohme, Rania A; Meltzer, Martin I; Katz, Mark A; Mintz, Eric D

2017-10-01

The devastating 2010 cholera epidemic in Haiti prompted the government to introduce oral cholera vaccine (OCV) in two high-risk areas of Haiti. We evaluated the direct costs associated with the government's first vaccine campaign implemented in August-September 2013. We analyzed data for major cost categories and assessed the efficiency of available campaign resources to vaccinate the target population. For a target population of 107,906 persons, campaign costs totaled $624,000 and 215,295 OCV doses were dispensed. The total vaccine and operational cost was $2.90 per dose; vaccine alone cost $1.85 per dose, vaccine delivery and administration $0.70 per dose, and vaccine storage and transport $0.35 per dose. Resources were greater than needed-our analyses suggested that approximately 2.5-6 times as many persons could have been vaccinated during this campaign without increasing the resources allocated for vaccine delivery and administration. These results can inform future OCV campaigns in Haiti.

Controlling cholera in the Ouest Department of Haiti using oral vaccines.

PubMed

Kirpich, Alexander; Weppelmann, Thomas A; Yang, Yang; Morris, John Glenn; Longini, Ira M

2017-04-01

Following the 2010 cholera outbreak in Haiti, a plan was initiated to provide massive improvements to the sanitation and drinking water infrastructure in order to eliminate cholera from the island of Hispaniola by 2023. Six years and a half billion dollars later, there is little evidence that any substantial improvements have been implemented; with increasing evidence that cholera has become endemic. Thus, it is time to explore strategies to control cholera in Haiti using oral cholera vaccines (OCVs). The potential effects of mass administration of OCVs on cholera transmission were assessed using dynamic compartment models fit to cholera incidence data from the Ouest Department of Haiti. The results indicated that interventions using an OCV that was 60% effective could have eliminated cholera transmission by August 2012 if started five weeks after the initial outbreak. A range of analyses on the ability of OCV interventions started January 1, 2017 to eliminate cholera transmission by 2023 were performed by considering different combinations of vaccine efficacies, vaccine administration rates, and durations of protective immunity. With an average of 50 weeks for the waiting time to vaccination and an average duration of three years for the vaccine-induced immunity, all campaigns that used an OCV with a vaccine efficacy of at least 60% successfully eliminated cholera transmission by 2023. The results of this study suggest that even with a relatively wide range of vaccine efficacies, administration rates, and durations of protective immunity, future epidemics could be controlled at a relatively low cost using mass administration of OCVs in Haiti.

Hurricane Matthew over Haiti seen by NASA MISR

NASA Image and Video Library

2016-10-04

On the morning of October 4, 2016, Hurricane Matthew passed over the island nation of Haiti. A Category 4 storm, it made landfall around 7 a.m. local time (5 a.m. PDT/8 a.m. EDT) with sustained winds over 145 mph. This is the strongest hurricane to hit Haiti in over 50 years. On October 4, at 10:30 a.m. local time (8:30 a.m. PDT/11:30 a.m. EDT), the Multi-angle Imaging SpectroRadiometer (MISR) instrument aboard NASA's Terra satellite passed over Hurricane Matthew. This animation was made from images taken by MISR's downward-pointing (nadir) camera is 235 miles (378 kilometers) across, which is much narrower than the massive diameter of Matthew, so only the hurricane's eye and a portion of the storm's right side are visible. Haiti is completely obscured by Matthew's clouds, but part of the Bahamas is visible to the north. Several hot towers are visible within the central part of the storm, and another at the top right of the image. Hot towers are enormous thunderheads that punch through the tropopause (the boundary between the lowest layer of the atmosphere, the troposphere, and the next level, the stratosphere). The rugged topography of Haiti causes uplift within the storm, generating these hot towers and fueling even more rain than Matthew would otherwise dump on the country. MISR has nine cameras fixed at different angles, which capture images of the same point on the ground within about seven minutes. This animation was created by blending images from these nine cameras. The change in angle between the images causes a much larger motion from south to north than actually exists, but the rotation of the storm is real motion. From this animation, you can get an idea of the incredible height of the hot towers, especially the one to the upper right. The counter-clockwise rotation of Matthew around its closed (cloudy) eye is also visible. These data were acquired during Terra orbit 89345. An animation is available at http://photojournal.jpl.nasa.gov/catalog/PIA21070

The tragedy of Haiti: A reason for major cultural change.

PubMed

Brown, Geraldine

2010-01-01

With the recent earthquake in Haiti, it is most befitting to discuss my travel to this poor country more than a decade ago. The travel was a mission that examined the health status and the education of residents in the capital city of Port- au-Prince. After close observation, it seems that the health and educational status then, today and since the tragedy, is basically the same with less, if any, possible improvement. This article examines the present state of health and education of the Haitian people, in the wake of its recent tragedy. Although, the people were very poor in economics, they were rich in culture and exhibited polite mannerisms that made me feel overly welcomed in their homes and to the few resources they had to offer It appears that in past years, this country was and still is noted as the poorest country in the Americas, however, it is not the poorest country in the Western Hemisphere. On many occasions, it has been publicly and widely reported that Haiti experienced political violence throughout its history. The government of Haiti is known for corruption. It also appears that an earthquake the magnitude of 7.0 would not have easily destroyed so many of its infrastructure and people, if in the past, the surrounding countries, including the United States, would have assisted in providing this country with safer and stronger foundations for buildings and especially shelter for the residents and the many visitors who were the true victims. Despite the repressive regime, Haiti's location, history and culture were very attractive to tourists in the 1960s and 1970s. Visitors returned home with memorable artifacts that included cave paintings, wood statues (figurines) and hand made jewelry.

Availability, prices and affordability of essential medicines in Haiti

PubMed Central

Chahal, Harinder Singh; St. Fort, Nazaire; Bero, Lisa

2013-01-01

Background Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. Methods We conducted a cross–sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. Results For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days’ wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days’ wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days’ wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. Conclusions The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most

["Tèt asanm pou la sante": ethnographic notes on international cooperation for health in Haiti].

PubMed

Esteves, Uliana

2016-01-01

This article discusses the functioning of a health-oriented development project pursued in an emergency situation and its impacts beyond its stated goals. The tripartite project between Brazil, Haiti, and Cuba was designed to strengthen Haiti's health and epidemiologic surveillance system, introduced in 2010 as part of the aid effort after the earthquake. An essentially ethnographic perspective is taken, with a focus on describing the practices and perspectives of the agents involved in the program. The networks of agents were mapped out, paying particular attention to translators, drivers, and journalists, who were understood as being "cooperation brokers". Finally, the article discusses the project's position in the broader context of international health initiatives in Haiti.

Defense.gov - Special Report: Haiti Earthquake Relief

Science.gov Websites

. Top Stories Medical Group Provides Assistance MANDRIN, Haiti, July 14, 2010 - Airmen with the 56th Medical Group provided optometry, dental and general services at the New Horizons medical site. Story assigned to Joint Task Force New Horizons have made major progress on their engineering and medical

Nepalese origin of cholera epidemic in Haiti.

PubMed

Frerichs, R R; Keim, P S; Barrais, R; Piarroux, R

2012-06-01

Cholera appeared in Haiti in October 2010 for the first time in recorded history. The causative agent was quickly identified by the Haitian National Public Health Laboratory and the United States Centers for Disease Control and Prevention as Vibrio cholerae serogroup O1, serotype Ogawa, biotype El Tor. Since then, >500 000 government-acknowledged cholera cases and >7000 deaths have occurred, the largest cholera epidemic in the world, with the real death toll probably much higher. Questions of origin have been widely debated with some attributing the onset of the epidemic to climatic factors and others to human transmission. None of the evidence on origin supports climatic factors. Instead, recent epidemiological and molecular-genetic evidence point to the United Nations peacekeeping troops from Nepal as the source of cholera to Haiti, following their troop rotation in early October 2010. Such findings have important policy implications for shaping future international relief efforts. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

Reducing under-five mortality through Hôpital Albert Schweitzer's integrated system in Haiti.

PubMed

Perry, Henry; Cayemittes, Michel; Philippe, Francois; Dowell, Duane; Dortonne, Jean Richard; Menager, Henri; Bottex, Erve; Berggren, Warren; Berggren, Gretchen

2006-05-01

The degree to which local health systems contribute to reductions in under-five mortality in severely impoverished settings has not been well documented. The current study compares the under-five mortality in the Hôpital Albert Schweitzer (HAS) Primary Health Care Service Area with that for Haiti in general. HAS provides an integrated system of community-based primary health care services, hospital care and community development. A sample of 10% of the women of reproductive age in the HAS service area was interviewed, and 2390 live births and 149 child deaths were documented for the period 1995-99. Under-five mortality rates were computed and compared with rates for Haiti. In addition, available data regarding inputs, processes and outputs for the HAS service area and for Haiti were assembled and compared. Under-five mortality was 58% less in the HAS service area, and mortality for children 12-59 months of age was 76% less. These results were achieved with an input of fewer physicians and hospital beds per capita than is available for Haiti nationwide, but with twice as many graduate nurses and auxiliary nurses per capita than are available nationwide, and with three cadres of health workers that do not exist nationwide: Physician Extenders, Health Agents and Community Health Volunteers. The population coverage of targeted child survival services was generally 1.5-2 times higher in the HAS service area than in rural Haiti. These findings support the conclusion that a well-developed system of primary health care, with outreach services to the household level, integrated with hospital referral care and community development programmes, can make a strong contribution to reducing infant and child mortality in severely impoverished settings.

A Country's Hope: The Haiti Scholarship Program

ERIC Educational Resources Information Center

Anderson, Jennifer R.

2007-01-01

The Haiti Scholarship Program is a USAID-funded effort managed by the American Institutes for Research (AIR) and implemented by local Haitian non-profit organization Le Fonds de Parrainage National (FPN) to provide scholarship support to more than 15,000 students in the five Haitian cities of Petit-Goave, Port-au-Prince, Saint-Marc, Gonaives, and…

Education and Conflict in Haiti: Rebuilding the Education Sector after the 2010 Earthquake. Special Report 245

ERIC Educational Resources Information Center

Luzincourt, Ketty; Gulbrandson, Jennifer

2010-01-01

In Haiti, education both promotes and ameliorates conflict. This report describes the education sector before the 2010 earthquake, then presents recommendations on how Haiti and the international community can increase access to and the quality of Haitian schools and modernize the organization and function of the national education sector.…

Recommendations for the establishment of the seismic code of Haiti

NASA Astrophysics Data System (ADS)

Pierristal, G.; Benito, B.; Cervera, J.; Belizaire, D.

2013-05-01

Haiti, because of his seismicity associated with plate boundary and several faults that cross the island of Hispaniola (Haiti-Dominican Republic), has been affected in the past by major earthquakes, which have caused loss of life and damage or considerable structural collapses (ex. 1771, 1842), sometimes the destruction of the cities. The recent earthquake of January 12, 2010, was the most destructive earthquake that any country has experienced in modern times, when we measure the number of people killed with respect to the population of a country (Cavallo et al. 2010). It's obvious that the major causes of theses losses are the lack of awareness of the population about the earthquakes, the absence of seismic code and quality control of the building. In this paper, we propose some recommendations for the establishment of the seismic code of Haiti in order to decrease physical and social impacts of earthquakes in the future. First of all, we present a theoretical part of concepts and fundamental elements to establish a seismic code, such as: description of the methodology for seismic hazard's assessment, presentation of the results in terms of acceleration maps for the whole country (in rock sites) and Uniform Hazard Spectrum (UHS) in the cities, and the criteria for soil classification and amplification factors for including site's effects, equivalent forces, etc. Then, we include a practical part where calculations and comparisons of five seismic codes of different countries (Eurocode 8, Spain, Canada, United States and Dominican Republic) are included, in order to have criteria for making the proposals for Haiti. Using the results of Benito et al (presented in this session S10) we compare the UHS in different cities of Haiti with the response spectrum derived from the application of the spectral shapes given by the aforementioned codes. Furthermore, the classification of soils and buildings have been also analyzed and contrasted with local data in order to

Seismic Catalogue and Seismic Network in Haiti

NASA Astrophysics Data System (ADS)

Belizaire, D.; Benito, B.; Carreño, E.; Meneses, C.; Huerfano, V.; Polanco, E.; McCormack, D.

2013-05-01

The destructive earthquake occurred on January 10, 2010 in Haiti, highlighted the lack of preparedness of the country to address seismic phenomena. At the moment of the earthquake, there was no seismic network operating in the country, and only a partial control of the past seismicity was possible, due to the absence of a national catalogue. After the 2010 earthquake, some advances began towards the installation of a national network and the elaboration of a seismic catalogue providing the necessary input for seismic Hazard Studies. This paper presents the state of the works carried out covering both aspects. First, a seismic catalogue has been built, compiling data of historical and instrumental events occurred in the Hispaniola Island and surroundings, in the frame of the SISMO-HAITI project, supported by the Technical University of Madrid (UPM) and Developed in cooperation with the Observatoire National de l'Environnement et de la Vulnérabilité of Haiti (ONEV). Data from different agencies all over the world were gathered, being relevant the role of the Dominican Republic and Puerto Rico seismological services which provides local data of their national networks. Almost 30000 events recorded in the area from 1551 till 2011 were compiled in a first catalogue, among them 7700 events with Mw ranges between 4.0 and 8.3. Since different magnitude scale were given by the different agencies (Ms, mb, MD, ML), this first catalogue was affected by important heterogeneity in the size parameter. Then it was homogenized to moment magnitude Mw using the empirical equations developed by Bonzoni et al (2011) for the eastern Caribbean. At present, this is the most exhaustive catalogue of the country, although it is difficult to assess its degree of completeness. Regarding the seismic network, 3 stations were installed just after the 2010 earthquake by the Canadian Government. The data were sent by telemetry thought the Canadian System CARINA. In 2012, the Spanish IGN together

Glucose-6-Phosphate Dehydrogenase Deficiency A− Variant in Febrile Patients in Haiti

PubMed Central

Carter, Tamar E.; Maloy, Halley; von Fricken, Michael; St. Victor, Yves; Romain, Jean R.; Okech, Bernard A.; Mulligan, Connie J.

2014-01-01

Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A−. We estimated the frequency of G6PDd A− in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A− allele (includes A− hemizygous males, A− homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. PMID:24891465

Glucose-6-phosphate dehydrogenase deficiency A- variant in febrile patients in Haiti.

PubMed

Carter, Tamar E; Maloy, Halley; von Fricken, Michael; St Victor, Yves; Romain, Jean R; Okech, Bernard A; Mulligan, Connie J

2014-08-01

Haiti is one of two remaining malaria-endemic countries in the Caribbean. To decrease malaria transmission in Haiti, primaquine was recently added to the malaria treatment public health policy. One limitation of primaquine is that, at certain doses, primaquine can cause hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd). In this study, we genotyped two mutations (A376G and G202A), which confer the most common G6PDd variant in West African populations, G6PDd A-. We estimated the frequency of G6PDd A- in a sample of febrile patients enrolled in an on-going malaria study who represent a potential target population for a primaquine mass drug administration. We found that 33 of 168 individuals carried the G6PDd A- allele (includes A- hemizygous males, A- homozygous or heterozygous females) and could experience toxicity if treated with primaquine. These data inform discussions on safe and effective primaquine dosing and future malaria elimination strategies for Haiti. © The American Society of Tropical Medicine and Hygiene.

"There Is a Lot that I Want to Do": Reflections on the Relief Efforts in Haiti

ERIC Educational Resources Information Center

Desgrottes, Maryse

2011-01-01

In October 2010, Harvard Educational Review editor Raygine DiAquoi interviewed Maryse Desgrottes, the mother of a close friend and a visible presence in the relief efforts in Petit Goave, Haiti. Desgrottes, a former physician's assistant turned educator and school superintendent, shares the story of her involvement in Haiti's relief efforts since…

Detection of Sickle Cell Hemoglobin in Haiti by Genotyping and Hemoglobin Solubility Tests

PubMed Central

Carter, Tamar E.; von Fricken, Michael; Romain, Jean R.; Memnon, Gladys; St. Victor, Yves; Schick, Laura; Okech, Bernard A.; Mulligan, Connie J.

2014-01-01

Sickle cell disease is a growing global health concern because infants born with the disorder in developing countries are now surviving longer with little access to diagnostic and management options. In Haiti, the current state of sickle cell disease/trait in the population is unclear. To inform future screening efforts in Haiti, we assayed sickle hemoglobin mutations using traditional hemoglobin solubility tests (HST) and add-on techniques, which incorporated spectrophotometry and insoluble hemoglobin separation. We also generated genotype data as a metric for HST performance. We found 19 of 202 individuals screened with HST were positive for sickle hemoglobin, five of whom did not carry the HbS allele. We show that spectrophotometry and insoluble hemoglobin separation add-on techniques could resolve false positives associated with the traditional HST approach, with some limitations. We also discuss the incorporation of insoluble hemoglobin separation observation with HST in suboptimal screening settings like Haiti. PMID:24957539

The Haiti earthquake: the provision of wound care for mass casualties utilizing negative-pressure wound therapy.

PubMed

Gabriel, Allen; Gialich, Shelby; Kirk, Julie; Edwards, Sheriden; Beck, Brooke; Sorocéanu, Alexandra; Nelson, Scott; Gabriel, Cassie; Gupta, Subhas

2011-10-01

Many months after the devastating earthquake in January 2010, wounds remain a major disease burden in Haiti. Since January 2010, through the efforts of corporations, nonprofit charitable organizations, and medical professionals, advanced wound care techniques, including negative-pressure wound therapy (NPWT), have been introduced into the wound care regimens of various hospitals in Haiti. In June 2010, the authors completed their second volunteer trip at a Haitian hospital specializing in orthopedic wounds. The medical team was composed of a plastic surgeon, orthopedic surgeon, anesthesiologist, medical assistant, scrub technician, and registered nurse (specializing in plastic surgery and orthopedics). The authors' team supplied NPWT devices, reticulated open-cell foam dressings, and canisters donated by Kinetic Concepts, Inc, San Antonio, Texas, for use at the hospital. This report describes the medical challenges in postearthquake Haiti (including limb salvage and infection), benefits of adjunctive use of NPWT/reticulated open-cell foam, and current wound care status in a Haitian orthopedic hospital. The future role of NPWT in Haiti and during mass catastrophe in a least-developed country is also discussed.

Expansion of Vaccination Services and Strengthening Vaccine-Preventable Diseases Surveillance in Haiti, 2010–2016

PubMed Central

Tohme, Rania A.; Francois, Jeannot; Cavallaro, Kathleen F.; Paluku, Gilson; Yalcouye, Idrissa; Jackson, Ernsley; Wright, Tracie; Adrien, Paul; Katz, Mark A.; Hyde, Terri B.; Faye, Pape; Kimanuka, Francine; Dietz, Vance; Vertefeuille, John; Lowrance, David; Dahl, Benjamin; Patel, Roopal

2017-01-01

Abstract. Following the 2010 earthquake, Haiti was at heightened risk for vaccine-preventable diseases (VPDs) outbreaks due to the exacerbation of long-standing gaps in the vaccination program and subsequent risk of VPD importation from other countries. Therefore, partners supported the Haitian Ministry of Health and Population to improve vaccination services and VPD surveillance. During 2010–2016, three polio, measles, and rubella vaccination campaigns were implemented, achieving a coverage > 90% among children and maintaining Haiti free of those VPDs. Furthermore, Haiti is on course to eliminate maternal and neonatal tetanus, with 70% of communes achieving tetanus vaccine two-dose coverage > 80% among women of childbearing age. In addition, the vaccine cold chain storage capacity increased by 91% at the central level and 285% at the department level, enabling the introduction of three new vaccines (pentavalent, rotavirus, and pneumococcal conjugate vaccines) that could prevent an estimated 5,227 deaths annually. Haiti moved from the fourth worst performing country in the Americas in 2012 to the sixth best performing country in 2015 for adequate investigation of suspected measles/rubella cases. Sentinel surveillance sites for rotavirus diarrhea and meningococcal meningitis were established to estimate baseline rates of those diseases prior to vaccine introduction and to evaluate the impact of vaccination in the future. In conclusion, Haiti significantly improved vaccination services and VPD surveillance. However, high dependence on external funding and competing vaccination program priorities are potential threats to sustaining the improvements achieved thus far. Political commitment and favorable economic and legal environments are needed to maintain these gains. PMID:29064356

Commodity Tracker: Mobile Application for Food Security Monitoring in Haiti

NASA Astrophysics Data System (ADS)

Chiu, M. T.; Huang, X.; Baird, J.; Gourley, J. R.; Morelli, R.; de Lanerolle, T. R.; Haiti Food Security Monitoring Mobile App Team

2011-12-01

Megan Chiu, Jason Baird, Xu Huang, Trishan de Lanerolle, Ralph Morelli, Jonathan Gourley Trinity College, Computer Science Department and Environmental Science Program, 300 Summit Street, Hartford, CT 06106 megan.chiu@trincoll.edu, Jason.baird@trincoll.edu, xu.huang@trincoll.edu, trishan.delanerolle@trincoll.edu, ralph.morelli@trincoll.edu, jonathan.gourley@trincoll.edu Price data for Haiti commodities such as rice and potatoes have been traditionally recorded by hand on paper forms for many years. The information is then entered onto computer manually, thus making the process a long and arduous one. With the development of the Haiti Commodity Tracker mobile app, we are able to make this commodity price data recording process more efficient. Officials may use this information for making inferences about the difference in commodity prices and for food distribution during critical time after natural disasters. This information can also be utilized by governments and aid agencies on their food assistance programs. Agronomists record the item prices from several sample sites in a marketplace and compare those results from other markets across the region. Due to limited connectivity in rural areas, data is first saved to the phone's database and then retransmitted to a central server via SMS messaging. The mobile app is currently being field tested by an international NGO providing agricultural aid and support in rural Haiti.

Is the Local Seismicity in Haiti Capable of Imaging the Northern Caribbean Subduction?

NASA Astrophysics Data System (ADS)

Corbeau, J.; Clouard, V.; Rolandone, F.; Leroy, S. D.; de Lepinay, B. M.

2017-12-01

The boundary between the Caribbean (CA) and North American (NAM) plates in the Hispaniola region is the western prolongation of the NAM plate subduction evolving from a frontal subduction in the Lesser Antilles to an oblique collision against the Bahamas platform in Cuba. We analyze P-waveforms arriving at 27 broadband seismic temporary stations deployed along a 200 km-long N-S transect across Haiti, during the Trans-Haiti project. We compute teleseismic receiver functions using the ETMTRF method, and determine crustal thickness and bulk composition (Vp/Vs) using the H-k stacking method. Three distinctive crustal domains are imaged. We relate these domains to crustal terranes that have been accreted along the plate boundary during the northeastwards displacement of the CA plate. We propose a N-S crustal profile across Haiti accounting for the surface geology, shallow structural history and these new seismological constraints. Local seismicity recorded by the temporary network from April 2013 to June 2014 is used to relocate the seismicity. A total of 593 events were identified with magnitudes ranging from 1.6 to 4.5. This local seismicity, predominantly shallow (< 20 km) and situated in the southern part of Haiti along the major Enriquillo-Plantain-Garden strike-slip fault zone (EPGFZ) and offshore in Gonâve Bay, helps us to image deep active structures. Moment tensors for earthquakes with magnitudes between 3 and 4 were calculated by full waveform inversion using the ISOLA software. The analysis of the new moment tensors for the Haiti upper lithosphere indicates that normal, thrust and strike-slip faulting are equitably distributed. We found strike-slip events along the EPGFZ, near the location of the January 12th, 2010 earthquake. Most of the normal events are located in the area of Enriquillo and Azuei lakes, while the thrust events are located on both sides of the southern Peninsula of Haiti. The preliminary seismic data of our Haitian network, even noisy

Report from the Field: Psychological First Aid for Haiti's Storm Orphans.

PubMed

Giraldo, Gloria

2008-07-01

In 2004, the final death toll in Haiti from Tropical Storm Jeanne was recorded at 3,006; of these, 2,826 in Gonaïves, a city floating in ruins. The road to Gonaïves was washed out, leaving the city and the department of Artibonite cut off for days from the rest of the country. Dr Juan Carlos Ch�vez, who headed the Cuban medical team in Haiti at the time, recalls that 17 Cuban health professionals were working in the area when the storm barrelled through, among the 400 already serving in the country. They were later joined by another 72 doctors, nurses, technicians and engineers sent directly from Cuba.

Personal review and justice analysis of nursing experiences in Haiti.

PubMed

Emmott, Helen

2008-08-01

Health care providers frequently struggle to develop wise applications of theoretical knowledge. As a nurse studying traditional approaches in ethics while simultaneously volunteering in Haiti, I wrestled with the notion of justice in the midst of radical material inequities. Paul Farmer, physician and anthropologist, provides an analytic perspective for health care providers who work in poor and underserved countries by expanding the liberation theology of the 1970s to include social applications. Analyzing my past experiences in Haiti using Farmer's methodology provided insight into my successes and failures and prompted me to search for personal and professional reasons to provide care for the poor in the future. This type of reflection is essential for health care providers who work with the underserved, regardless of their religion or the country in which they work.

Submicroscopic malaria infections in pregnant women from six departments in Haiti.

PubMed

Elbadry, Maha A; Tagliamonte, Massimiliano S; Raccurt, Christian P; Lemoine, Jean F; Existe, Alexandre; Boncy, Jacques; Weppelmann, Thomas A; Dame, John B; Okech, Bernard A

2017-08-01

To describe the epidemiology of malaria in pregnancy in Haiti. Cross-sectional study among pregnant women in six departments of Haiti. After obtaining informed consent, whole blood samples and demographic surveys were collected to investigate malaria prevalence, anaemia and socio-behavioural risk factors for infection, respectively. A total of 311 pregnant women were screened for Plasmodium falciparum infection using a rapid diagnostic test (RDT), microscopy and a novel, quantitative reverse transcriptase polymerase chain reaction method (qRT-PCR). Overall, 1.2% (4/311) of pregnant women were tested positive for malaria infection by both microscopy and RDT. However, using the qRT-PCR, 16.4% (51/311) of pregnant women were positive. The prevalence of malaria infection varied with geographical locations ranging between 0% and 46.4%. Additionally, 53% of pregnant women had some form of anaemia; however, no significant association was found between anaemia and submicroscopic malaria infection. The socio-behavioural risk factors identified to be protective of malaria infection were marital status (P < 0.05) and travel within one month prior to screening (P < 0.05). This study is the first to document the high prevalence of submicroscopic malaria infections among pregnant women in Haiti and identify social and behavioural risk factors for disease transmission. © 2017 John Wiley & Sons Ltd.

Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care.

PubMed

Jacobs, Lee D; Judd, Thomas M; Bhutta, Zulfiqar A

2016-01-01

The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries.To create a major change in Haiti's health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic "community care grids" to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis.We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti's health care system will be among the leaders in that region.

U.S. Haiti Policy: An Evolving Comprehensive, Multilateral Approach

DTIC Science & Technology

2011-03-24

disaster; a cholera -stricken capital region; and an unresolved NOV 10 national election. Haiti can start anew, building on the current ravages. Former...have sustained limited military engagements to respond to threats emanating in Venezuela, Mexico , and throughout the Americas as drug cartels and

Organize or Die: Farm School Pedagogy and the Political Ecology of the Agroecological Transition in Rural Haiti

ERIC Educational Resources Information Center

Moore, Sophie Sapp

2017-01-01

This article examines the political and pedagogical role of the farm school in Haiti's largest and oldest peasants' movement, the Peasants' Movement of Papaye (MPP). It draws upon ongoing ethnographic research with MPP as well as documentary and historical analyses of agrarian politics in Haiti to situate the movement's land-based decolonial…

Risk Factors Early in the 2010 Cholera Epidemic, Haiti

PubMed Central

Cartwright, Emily; Loharikar, Anagha; Routh, Janell; Gaines, Joanna; Fouché, Marie-Délivrance Bernadette; Jean-Louis, Reginald; Ayers, Tracy; Johnson, Dawn; Tappero, Jordan W.; Roels, Thierry H.; Archer, W. Roodly; Dahourou, Georges A.; Mintz, Eric; Quick, Robert; Mahon, Barbara E.

2011-01-01

During the early weeks of the cholera outbreak that began in Haiti in October 2010, we conducted a case–control study to identify risk factors. Drinking treated water was strongly protective against illness. Our results highlight the effectiveness of safe water in cholera control. PMID:22099118

[Hepatobiliary fascioliasis and echinococcosis/hydatidosis in domestic animals in Haiti].

PubMed

Blaise, J; Raccurt, C P

2007-12-01

In Haiti, hepatobiliary fascioliasis and hepatic hydatid cysts cause major economic losses among livestock. Surveys show high prevalence rates for bovine distomatosis caused by Fasciola hepatica (10.7% to 22.78%). Among small ruminants, the prevalence of distomatosis is low (sheep: 3.2%, goats: 0.9%) although Dicrocoelium dendriticum is found in 1.1% of sheep. Hepatic hydatidosis is more common among pigs (5.2%) and sheep (2.1%) than among goats (0.9%) and cattle (0.3%). In the case of dogs, 21% excrete egg-bearing segments in their faeces and 25% harbour Echinococcus granulosus in the small intestine. As a result of local dietary habits (consumption of raw cress), environmental pollution by animal faeces, poverty and poor standards of hygiene in Haiti, these flatworms pose serious health risks to the population, even though this is largely unknown at present.

Idioms of distress, ethnopsychology, and the clinical encounter in Haiti's Central Plateau.

PubMed

Keys, Hunter M; Kaiser, Bonnie N; Kohrt, Brandon A; Khoury, Nayla M; Brewster, Aimée-Rika T

2012-08-01

Haiti's 2010 earthquake mobilized mental health and psychosocial interventions from across the globe. However, failure to understand how psychological distress is communicated between lay persons and health workers in rural clinics, where most Haitians access care, has been a major limitation in providing mental health services. The goal of this study was to map idioms of distress onto Haitian ethnopsychologies in a way that promotes improved communication between lay persons and clinicians in rural Haiti. In Haiti's Central Plateau, an ethnographic study was conducted in May and June 2010, utilizing participant observation in rural clinics, 31 key informant interviews, 11 focus groups, and four case studies. Key informants included biomedical practitioners, traditional healers, community leaders, and municipal and religious figures. Deductive and inductive themes were coded using content analysis (inter-rater reliability > 0.70). Forty-four terms for psychological distress were identified. Head (tèt) or heart (kè) terms comprise 55% of all qualitative text segments coded for idioms of distress. Twenty-eight of 142 observed patient-clinician contacts involved persons presenting with tèt terms, while 29 of the 142 contacts were presentations with kè terms. Thus, 40% of chief complaints were conveyed in either head or heart terms. Interpretations of these terms differed between lay and clinical groups. Lay respondents had broad and heterogeneous interpretations, whereas clinicians focused on biomedical concepts and excluded discussion of mental health concerns. This paper outlines preliminary evidence regarding the psychosocial dimensions of tèt and kè-based idioms of distress and calls for further exploration. Holistic approaches to mental healthcare in Haiti's Central Plateau should incorporate local ethnopsychological frameworks alongside biomedical models of healthcare. Copyright © 2012 Elsevier Ltd. All rights reserved.

Household food insecurity is associated with childhood malaria in rural Haiti.

PubMed

Pérez-Escamilla, Rafael; Dessalines, Michael; Finnigan, Mousson; Pachón, Helena; Hromi-Fiedler, Amber; Gupta, Nishang

2009-11-01

Haiti is the poorest country in the Western Hemisphere and is heavily affected by food insecurity and malaria. To find out if these 2 conditions are associated with each other, we studied a convenience sample of 153 women with children 1-5 y old in Camp Perrin, South Haiti. Household food insecurity was assessed with the 16-item Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale previously validated in the target communities. ELCSA's reference time period was the 3 mo preceding the survey and it was answered by the mother. Households were categorized as either food secure (2%; ELCSA score = 0), food insecure/very food insecure (42.7%; ELCSA score range: 1-10), or severely food insecure (57.3%; ELCSA score range: 11-16). A total of 34.0% of women reported that their children had malaria during the 2 mo preceding the survey. Multivariate analyses showed that severe food insecure was a risk factor for perceived clinical malaria (odds ratio: 5.97; 95% CI: 2.06-17.28). Additional risk factors for perceived clinical malaria were as follows: not receiving colostrum, poor child health (via maternal self-report), a child BMI <17 kg/m(2), and child vitamin A supplementation more than once since birth. Findings suggest that policies and programs that address food insecurity are also likely to reduce the risk of malaria in Haiti.

Uncovering the 2010 Haiti earthquake death toll

NASA Astrophysics Data System (ADS)

Daniell, J. E.; Khazai, B.; Wenzel, F.

2013-05-01

Casualties are estimated for the 12 January 2010 earthquake in Haiti using various reports calibrated by observed building damage states from satellite imagery and reconnaissance reports on the ground. By investigating various damage reports, casualty estimates and burial figures, for a one year period from 12 January 2010 until 12 January 2011, there is also strong evidence that the official government figures of 316 000 total dead and missing, reported to have been caused by the earthquake, are significantly overestimated. The authors have examined damage and casualties report to arrive at their estimation that the median death toll is less than half of this value (±137 000). The authors show through a study of historical earthquake death tolls, that overestimates of earthquake death tolls occur in many cases, and is not unique to Haiti. As death toll is one of the key elements for determining the amount of aid and reconstruction funds that will be mobilized, scientific means to estimate death tolls should be applied. Studies of international aid in recent natural disasters reveal that large distributions of aid which do not match the respective needs may cause oversupply of help, aggravate corruption and social disruption rather than reduce them, and lead to distrust within the donor community.

Evaluation of dihydrofolate reductase and dihydropteroate synthetase genotypes that confer resistance to sulphadoxine-pyrimethamine in Plasmodium falciparum in Haiti

PubMed Central

2012-01-01

Background Malaria caused by Plasmodium falciparum infects roughly 30,000 individuals in Haiti each year. Haiti has used chloroquine (CQ) as a first-line treatment for malaria for many years and as a result there are concerns that malaria parasites may develop resistance to CQ over time. Therefore it is important to prepare for alternative malaria treatment options should CQ resistance develop. In many other malaria-endemic regions, antifolates, particularly pyrimethamine (PYR) and sulphadoxine (SDX) treatment combination (SP), have been used as an alternative when CQ resistance has developed. This study evaluated mutations in the dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes that confer PYR and SDX resistance, respectively, in P. falciparum to provide baseline data in Haiti. This study is the first comprehensive study to examine PYR and SDX resistance genotypes in P. falciparum in Haiti. Methods DNA was extracted from dried blood spots and genotyped for PYR and SDX resistance mutations in P. falciparum using PCR and DNA sequencing methods. Sixty-one samples were genotyped for PYR resistance in codons 51, 59, 108 and 164 of the dhfr gene and 58 samples were genotyped for SDX resistance codons 436, 437, 540 of the dhps gene in P. falciparum. Results Thirty-three percent (20/61) of the samples carried a mutation at codon 108 (S108N) of the dhfr gene. No mutations in dhfr at codons 51, 59, 164 were observed in any of the samples. In addition, no mutations were observed in dhps at the three codons (436, 437, 540) examined. No significant difference was observed between samples collected in urban vs rural sites (Welch’s T-test p-value = 0.53 and permutations p-value = 0.59). Conclusion This study has shown the presence of the S108N mutation in P. falciparum that confers low-level PYR resistance in Haiti. However, the absence of SDX resistance mutations suggests that SP resistance may not be present in Haiti. These results have important

Cholera in Haiti and Other Caribbean Regions, 19th Century

PubMed Central

Szabo, Victoria

2011-01-01

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833–1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850–1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865–1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands. PMID:22099117

Tsunami waves generated by dynamically triggered aftershocks of the 2010 Haiti earthquake

NASA Astrophysics Data System (ADS)

Ten Brink, U. S.; Wei, Y.; Fan, W.; Miller, N. C.; Granja, J. L.

2017-12-01

Dynamically-triggered aftershocks, thought to be set off by the passage of surface waves, are currently not considered in tsunami warnings, yet may produce enough seafloor deformation to generate tsunamis on their own, as judged from new findings about the January 12, 2010 Haiti earthquake tsunami in the Caribbean Sea. This tsunami followed the Mw7.0 Haiti mainshock, which resulted from a complex rupture along the north shore of Tiburon Peninsula, not beneath the Caribbean Sea. The mainshock, moreover, had a mixed strike-slip and thrust focal mechanism. There were no recorded aftershocks in the Caribbean Sea, only small coastal landslides and rock falls on the south shore of Tiburon Peninsula. Nevertheless, a tsunami was recorded on deep-sea DART buoy 42407 south of the Dominican Republic and on the Santo Domingo tide gauge, and run-ups of ≤3 m were observed along a 90-km-long stretch of the SE Haiti coast. Three dynamically-triggered aftershocks south of Haiti have been recently identified within the coda of the mainshock (<200 s) by analyzing P wave arrivals recorded by dense seismic arrays, parsing the arrivals into 20-s-long stacks, and back-projecting the arrivals to the vicinity of the main shock (50-300 km). Two of the aftershocks, coming 20-40 s and 40-60 s after the mainshock, plot along NW-SE-trending submarine ridges in the Caribbean Sea south of Haiti. The third event, 120-140 s was located along the steep eastern slope of Bahoruco Peninsula, which is delineated by a normal fault. Forward tsunami models show that the arrival times of the DART buoy and tide gauge times are best fit by the earliest of the three aftershocks, with a Caribbean source 60 km SW of the mainshock rupture zone. Preliminary inversion of the DART buoy time series for fault locations and orientations confirms the location of the first source, but requires an additional unidentified source closer to shore 40 km SW of the mainshock rupture zone. This overall agreement between

Migration, Remittances and Educational Outcomes: The Case of Haiti

ERIC Educational Resources Information Center

Bredl, Sebastian

2011-01-01

This paper empirically investigates how migration and the receipt of remittances affect educational outcomes in Haiti. Based on a theoretical approach it tries to disentangle the effects of both phenomena that have mostly been jointly modeled in previous literature. The results suggest that remittances play an important role for poor households in…

Development Assistance in Haiti: Where Has the Money Gone?

DTIC Science & Technology

2014-12-01

the oversight from the United Nations on all of the aid money entering Haiti, alleviating President Préval of the temptation was a justifiable... Suicide Alexander Pétion 1807–1818 Died in Office Jean Pierre Boyer 1818–1843 Overthrown Riviere Rivière-Hérard 1843–1844 Overthrown Philippe

Peripartum cardiomyopathy in the Hospital Albert Schweitzer District of Haiti.

PubMed

Fett, James D; Carraway, Robert D; Dowell, Duane L; King, Mary Etta; Pierre, Ronald

2002-05-01

This report details current epidemiologic information on peripartum cardiomyopathy in 1 district of Haiti and represents the initial report of an ongoing investigation that addresses potential etiologic and prognostic factors. Another goal is to alert the medical community of what appears to be a high-incidence area. A detailed peripartum cardiomyopathy registry has been implemented to include a review of case records from 1994 to 2000 and subsequently to identify new cases from February 1, 2000, to July 1, 2001. The Hospital Albert Schweitzer District of Haiti is a 600-square mile area with approximately 258,000 population served by a hospital, an associated clinic, and outlying health centers. There are approximately 7740 live births annually. This report details epidemiologic information on the HAS District peripartum cardiomyopathy patients including incidence, mortality rate, complications, and prognostic factors. There were 47 confirmed patients (retrospective cohort, 20 patients; prospective cohort, 27 patients), which was approximately 1 case per 400 live births (compared with an incidence of 1 case per 3000 to 4000 live births in the United States). There were 4 deaths (14% of 29 patients with follow-up), and 7 complications (pulmonary embolism, 1 case; hemiplegia, 1 case; subsequent deterioration of heart function, 5 cases). The prognosis for subsequent pregnancy was 4 of 5 cases (80%) of recurrent congestive heart failure. Peripartum cardiomyopathy appears to be relatively common in the Hospital Albert Schweitzer District of Haiti. A core group of patients is identified for ongoing epidemiologic and immunohematologic investigation of risk factors and potential etiologic factors.

Modeling the Effect of Water, Sanitation, and Hygiene and Oral Cholera Vaccine Implementation in Haiti

PubMed Central

Chun-Hai Fung, Isaac; Fitter, David L.; Borse, Rebekah H.; Meltzer, Martin I.; Tappero, Jordan W.

2013-01-01

In 2010, toxigenic Vibrio cholerae was newly introduced to Haiti. Because resources are limited, decision-makers need to understand the effect of different preventive interventions. We built a static model to estimate the potential number of cholera cases averted through improvements in coverage in water, sanitation and hygiene (WASH) (i.e., latrines, point-of-use chlorination, and piped water), oral cholera vaccine (OCV), or a combination of both. We allowed indirect effects and non-linear relationships between effect and population coverage. Because there are limited incidence data for endemic cholera in Haiti, we estimated the incidence of cholera over 20 years in Haiti by using data from Malawi. Over the next two decades, scalable WASH interventions could avert 57,949–78,567 cholera cases, OCV could avert 38,569–77,636 cases, and interventions that combined WASH and OCV could avert 71,586–88,974 cases. Rate of implementation is the most influential variable, and combined approaches maximized the effect. PMID:24106189

Demonstration of the Use of Remote Temperature Monitoring Devices in Vaccine Refrigerators in Haiti.

PubMed

Cavallaro, Kathleen F; Francois, Jeannot; Jacques, Roody; Mentor, Derline; Yalcouye, Idrissa; Wilkins, Karen; Mueller, Nathan; Turner, Rebecca; Wallace, Aaron; Tohme, Rania A

After the 2010 earthquake, Haiti committed to introducing 4 new antigens into its routine immunization schedule, which required improving its cold chain (ie, temperature-controlled supply chain) and increasing vaccine storage capacity by installing new refrigerators. We tested the feasibility of using remote temperature monitoring devices (RTMDs) in Haiti in a sample of vaccine refrigerators fueled by solar panels, propane gas, or electricity. We analyzed data from 16 RTMDs monitoring 24 refrigerators in 15 sites from March through August 2014. Although 5 of the 16 RTMDs exhibited intermittent data gaps, we identified typical temperature patterns consistent with refrigerator door opening and closing, propane depletion, thermostat insufficiency, and overstocking. Actual start-up, annual maintenance, and annual electricity costs for using RTMDs were $686, $179, and $9 per refrigerator, respectively. In Haiti, RTMD use was feasible. RTMDs could be prioritized for use with existing refrigerators with high volumes of vaccines and new refrigerators to certify their functionality before use. Vaccine vial monitors could provide additional useful information about cumulative heat exposure and possible vaccine denaturation.

Ground water in the Cul-de-Sac Plain, Haiti

USGS Publications Warehouse

Taylor, George C.; Lemoine, Rémy C.

1949-01-01

The Cul-de-Sac Plain is perhaps the most important agricultural area in Haiti because of its nearness and accessibility to Port-au-Prince, the nation's capital, metropolis, and principal seaport. Most of the agricultural produce consumed in Port-au-Prince as well as a considerable part of that exported from Haiti is grown in the plain.Because of variable and poorly distributed rainfall, high temperature, and high evaporation, semiarid climatic conditions prevail in the plain. Irrigation is, therefore, necessary for successful farming. There are no regulatory or storage facilities on the streams that enter the plain, but the mean and low-water stream flow and the discharge of springs are almost entirely appropriated for irrigation. Ground water has been utilized for irrigation to an increasing extent by the Haitian American Sugar Company, which has put down about 100 wells in the plain since 1919.Outside the existing irrigated areas of the plain are large tracts of potentially irrigable land that are uncultivated and agriculturally unproductive for lack of water. The object of the present study was to determine the possibilities of bringing these lands into cultivation by irrigation from wells. This study was part of a larger program of the Food Supply Division, Institute of Inter-American Affairs, to increase the production of food in Haiti.From September through November 1948 the senior author, a member of the U. S. Geological Survey, spent three months in the field in an investigation of the geology and ground-water resources of the Cul-de-Sac Plain. He was ably assisted by Mr. Rémy C. Lemoine, Haitian engineer-geologist, employed by the Food Supply Division. The field work included principally the geologic mapping of' the plain and the adjacent mountain borders, a ground-water inventory of existing wells and springs, and a general evaluation of significant geologic and hydrologic features.

Strengthening healthcare delivery in Haiti through nursing continuing education.

PubMed

Clark, M; Julmisse, M; Marcelin, N; Merry, L; Tuck, J; Gagnon, A J

2015-03-01

The aim of this paper was to (1) highlight nursing continuing education as a key initiative for strengthening healthcare delivery in low-resource settings, and (2) provide an example of a nursing continuing education programme in Haiti. Haiti and other low-resource settings face extreme challenges including severe shortages of healthcare workers, high rates of nurse out-migration and variations in nurse competency at entry-to-practice. Nursing continuing education has the potential to address these challenges and improve healthcare delivery through enhanced nurse performance and retention; however, it is underutilized in low-resource settings. A case study is presented from the Hôpital Universitaire de Mirebalais in Mirebalais, Haiti of a new nursing continuing education programme called the Beyond Expert Program. The case study highlights eight key dimensions of nursing continuing education in low-resource settings: (1) involving local stakeholders in planning process, (2) targeting programme to nurse participant level and area of care, (3) basing course content on local context, (4) including diverse range of nursing topics, (5) using participatory teaching methods, (6) addressing resource constraints in time and scheduling, (7) evaluating and monitoring outcomes, and (8) establishing partnerships. The case study provides guidance for others wishing to develop programmes in similar settings. Creating a nursing continuing education programme in a low-resource setting is possible when there is commitment and engagement for nursing continuing education at all levels of the organization. Our report suggests a need for policy-makers in resource-limited settings to make greater investments in nursing continuing education as a focus of human resources for health, as it is an important strategy for promoting nurse retention, building the knowledge and skill of the existing nursing workforce, and raising the image of nursing in low-resource settings. © 2015

Orthopedic Activity in Field Hospitals Following Earthquakes in Nepal and Haiti : Variability in Injuries Encountered and Collaboration with Local Available Resources Drive Optimal Response.

PubMed

Bar-On, Elhanan; Blumberg, Nehemia; Joshi, Amit; Gam, Arnon; Peyser, Amos; Lee, Evgeny; Kashichawa, Shree Krishna; Morose, Alexander; Schein, Ophir; Lehavi, Amit; Kreiss, Yitshak; Bader, Tarif

2016-09-01

Field hospitals have been deployed by the Israel Defense Forces (IDF) Medical Corps in numerous disaster events. Two recent deployments were following earthquakes in Haiti in 2010 and in Nepal in 2015. Despite arrival in similar timetables, the mode of operation was different-independently in Haiti and in collaboration with a local hospital in Nepal. The pathology encountered in the two hospitals and the resultant treatment requirements were significantly different between the two events. The purpose of this study was to analyze these differences and their implications for preparation and planning of future deployments. Data were obtained from IDF records and analyzed using SPSS™ software. 1686 patients were treated in Nepal versus 1111 in Haiti. The caseload in Nepal included significantly less earthquake-related injuries (26 vs. 66 %) with 28 % of them sustaining fractures versus 47 % in Haiti. Femoral fractures accounted for 7.9 % of fractures in Nepal versus 26.4 % in Haiti with foot fractures accounting for 23.8 and 6.4 %, respectively. The rate of open fracture was similar at 29.4 % in Nepal and 27.5 % in Haiti. 18.1 % of injured patients in Nepal underwent surgery, and 32.9 % of which was skeletal compared to 32 % surgical cases (58.8 % skeletal) in Haiti. 74.2 % of patients in Nepal and 34.3 % in Haiti were treated for pathology unrelated to the earthquake. The reasons for the variability in activities between the two hospitals include the magnitude of the disaster, the functionality of the local medical system which was relatively preserved in Nepal and destroyed in Haiti and the mode of operation which was independent in Haiti and collaborative with a functioning local hospital in Nepal. Emergency medical teams (EMTs) may encounter variable caseloads despite similar disaster scenarios. Advance knowledge of the magnitude of the disaster, the functionality of the local medical system, and the collaborative possibilities will help in planning

A comparison of the medium-term impact and recovery of the Pakistan floods and the Haiti earthquake: objective and subjective measures.

PubMed

Weiss, William M; Kirsch, Thomas D; Doocy, Shannon; Perrin, Paul

2014-06-01

The 2010 Haiti earthquake and Pakistan floods were similar in their massive human impact. Although the specific events were very different, the humanitarian response to disasters is supposed to achieve the same ends. This paper contrasts the disaster effects and aims to contrast the medium-term response. In January 2011, similarly structured population-based surveys were carried out in the most affected areas using stratified cluster designs (80×20 in Pakistan and 60×20 in Haiti) with probability proportional to size sampling. Displacement persisted in Haiti and Pakistan at 53% and 39% of households, respectively. In Pakistan, 95% of households reported damage to their homes and loss of income or livelihoods, and in Haiti, the rates were 93% and 85%, respectively. Frequency of displacement, and income or livelihood loss, were significantly higher in Pakistan, whereas disaster-related deaths or injuries were significantly more prevalent in Haiti. Given the rise in disaster frequency and costs, and the volatility of humanitarian funding streams as a result of the recent global financial crisis, it is increasingly important to measure the impact of humanitarian response against the goal of a return to normalcy.

3D Velocity Structure in Southern Haiti from Local Earthquake Tomography

NASA Astrophysics Data System (ADS)

Douilly, R.; Ellsworth, W. L.; Kissling, E. H.; Freed, A. M.; Deschamps, A.; de Lepinay, B. M.

2016-12-01

We investigate 3D local earthquake tomography for high-quality travel time arrivals from aftershocks following the 2010 M7.0 Haiti earthquake on the Léogâne fault. The data were recorded by 35 stations, including 19 ocean bottom seismometers, from which we selected 595 events to simultaneously invert for hypocenter location and 3D Vp and Vs velocity structures in southern Haiti. We performed several resolution tests and concluded that clear features can be recovered to a depth of 15 km. At 5km depth we distinguish a broad low velocity zone in the Vp and Vs structure offshore near Gonave Island, which correlate with layers of marine sediments. Results show a pronounced low velocity zone in the upper 5 km across the city of Léogâne, which is consistent with the sedimentary basin location from geologic map. At 10 km depth, we detect a low velocity anomaly offshore near the Trois Baies fault and a NW-SE directed low velocity zone onshore across Petit-Goâve and Jacmel, which is consistent with a suspected fault from a previous study and that we refer to it in our study as the Petit-Goâve-Jacmel fault (PGJF). These observations suggest that low velocity structures delineate fault structures and the sedimentary basins across the southern peninsula, which is extremely useful for seismic hazard assessment in Haiti.

What hope for Haiti?

PubMed

Di Blasi, F

1992-01-01

The population, environmental, and economic problems of Haiti must be solved through a national change in attitude, an emphasis on the individual value of children, a social concern for urgent action on sustainable development, and shared responsibility in the international community. The impact of colonialism was to lay waste to subsistence practices which were ecologically balanced. This first nation of self-liberated slaves has problems deeply rooted in the past, which have been worsened by the ruling elite's exploitation. There is extreme poverty, boat people, deforestation, environmental degradation, civil liberty abuses, and a struggle for democracy. Population growth as well as, indirectly, death, hunger, and disease, have contributed to the immigration of Haitians to the US, Canada, France, and neighboring islands. Fertility has been high for the past 20 years. The family planning challenges are discussed in light of the 10% acceptance rate and met demand. The host country's ability to cope with the burden of supplying employment, social services, and legal protection accounts for the reluctance to accept greater numbers of Haitians. Rural-to-urban migration has created nightmares within Haiti. Cite Soleil has a population density of 25,000 people/sq. kilometer, and more than 33% of rural areas is unfit for habitation. The urban slums offer a substandard quality of life due to infiltration of sea water into the soil which prohibits vegetative growth, due to sanitation deficits, and due to inadequate clean water supplies. The example of a small sugar merchant with an income of $40/month reflects the ability to survive but with no provision for empowerment or betterment for the future for the grandchildren in her care. Captain Jacques-Yves Cousteau attests to the difficulties and, maybe, impossibilities of turning around the process of environmental devastation and overpopulation. The ecological problems are primarily due to salinization and deforestation

Selection of common bean to broad environmental adaptation in Haiti

USDA-ARS?s Scientific Manuscript database

Common bean (Phaseolus vulgaris L.) cultivars in Haiti need adaptation to a broad range of environments and resistance to the most important diseases such as Bean Golden Yellow Mosaic Virus. The Legume Breeding Program (LBP), a collaborative effort of the AREA project (USAID funded through IFAS/Univ...

Assessment of Risk of Cholera in Haiti following Hurricane Matthew.

PubMed

Khan, Rakib; Anwar, Rifat; Akanda, Shafqat; McDonald, Michael D; Huq, Anwar; Jutla, Antarpreet; Colwell, Rita

2017-09-01

Damage to the inferior and fragile water and sanitation infrastructure of Haiti after Hurricane Matthew has created an urgent public health emergency in terms of likelihood of cholera occurring in the human population. Using satellite-derived data on precipitation, gridded air temperature, and hurricane path and with information on water and sanitation (WASH) infrastructure, we tracked changing environmental conditions conducive for growth of pathogenic vibrios. Based on these data, we predicted and validated the likelihood of cholera cases occurring past hurricane. The risk of cholera in the southwestern part of Haiti remained relatively high since November 2016 to the present. Findings of this study provide a contemporary process for monitoring ground conditions that can guide public health intervention to control cholera in human population by providing access to vaccines, safe WASH facilities. Assuming current social and behavioral patterns remain constant, it is recommended that WASH infrastructure should be improved and considered a priority especially before 2017 rainy season.

Maternal and congenital syphilis in rural Haiti.

PubMed

Lomotey, Chaylah J; Lewis, Judy; Gebrian, Bette; Bourdeau, Royneld; Dieckhaus, Kevin; Salazar, Juan C

2009-09-01

A study was conducted to assess the prevalence of maternal syphilis and estimate the rate of congenital syphilis in five rural villages surrounding Jeremie, Haiti. This research was a retrospective observational study. Data were extracted from the Haitian Health Foundation's public health database and verified through original clinical paper records, death certificates, midwife reports, and discussions with community health workers. Data were analyzed by chi-square analysis, bivariate correlations, and two-tailed t-test for independent samples. Of the 410 women tested for syphilis, 31 (7.6%) were sero-reactive. Average gestation at time of testing was 25 weeks, which correlated with entry into prenatal care at an average of 23 weeks. Women who tested positive during pregnancy were more likely to have had a negative pregnancy outcome than those who did not (chi square = 16.4; P < 0.0001). The estimated rate of congenital syphilis in the region was 767 per 100,000 live births. Maternal syphilis is prevalent in rural Haiti. This prevalence combined with late entry into prenatal care contributes to adverse pregnancy outcomes and a high estimated rate of congenital syphilis. More research is needed on congenital syphilis and prenatal-careseeking practices of rural Haitian women in order to understand the impact of maternal syphilis in the region and improve pregnancy outcomes.

The trauma signature of 2016 Hurricane Matthew and the psychosocial impact on Haiti

PubMed Central

Shultz, James M.; Cela, Toni; Marcelin, Louis Herns; Espinola, Maria; Heitmann, Ilva; Sanchez, Claudia; Jean Pierre, Arielle; Foo, Cheryl YunnShee; Thompson, Kip; Klotzbach, Philip; Espinel, Zelde; Rechkemmer, Andreas

2016-01-01

ABSTRACT Background. Hurricane Matthew was the most powerful tropical cyclone of the 2016 Atlantic Basin season, bringing severe impacts to multiple nations including direct landfalls in Cuba, Haiti, Bahamas, and the United States. However, Haiti experienced the greatest loss of life and population disruption. Methods. An established trauma signature (TSIG) methodology was used to examine the psychological consequences of Hurricane Matthew in relation to the distinguishing features of this event. TSIG analyses described the exposures of Haitian citizens to the unique constellation of hazards associated with this tropical cyclone. A hazard profile, a matrix of psychological stressors, and a “trauma signature” summary for the affected population of Haiti - in terms of exposures to hazard, loss, and change - were created specifically for this natural ecological disaster. Results. Hazard characteristics of this event included: deluging rains that triggered mudslides along steep, deforested terrain; battering hurricane winds (Category 4 winds in the “eye-wall” at landfall) that dismantled the built environment and launched projectile debris; flooding “storm surge” that moved ashore and submerged villages on the Tiburon peninsula; and pummeling wave action that destroyed infrastructure along the coastline. Many coastal residents were left defenseless to face the ravages of the storm. Hurricane Matthew's slow forward progress as it remained over super-heated ocean waters added to the duration and degree of the devastation. Added to the havoc of the storm itself, the risks for infectious disease spread, particularly in relation to ongoing epidemics of cholera and Zika, were exacerbated. Conclusions. Hurricane Matthew was a ferocious tropical cyclone whose meteorological characteristics amplified the system's destructive force during the storm's encounter with Haiti, leading to significant mortality, injury, and psychological trauma. PMID:28321360

Haiti and the politics of governance and community responses to Hurricane Matthew

PubMed Central

Marcelin, Louis Herns; Cela, Toni; Shultz, James M.

2016-01-01

ABSTRACT This article examines disaster preparedness and community responses to Hurricane Matthew in semi-urban and rural towns and villages in Grande-Anse, Haiti. Based on an ethnographic study conducted in the department of Grande-Anse one week after the hurricane made landfall in Haiti, the article focuses on the perspectives of citizens, community-based associations and local authorities in the affected areas. Sixty-three (63) interviews and 8 community meetings (focus groups) were conducted in 11 impacted sites in 8 communes. Results suggest that preexisting conditions in impacted communities, rather than deliberate and coordinated disaster management strategies, shaped levels of preparedness for and response to the disaster. Affected populations relied primarily on family networks and local forms of solidarity to attend to basic needs such as shelter, health and food. The main argument presented is that Haiti, by virtue of its geographic location, lack of resources, institutional fragility and vulnerability, must systematically integrate community-based assets and capacities in its responses to and management of disasters. Further, it is critical for the government, Haitian institutions, and society to apply integrated risk reduction and management and disaster preparedness measures in all aspects of life, if the country is to survive the many disasters to come in a time of climate change. These measures should be embedded in recovery and reconstruction efforts after Hurricane Matthew. PMID:28321361

Spatial relationships between tropical cyclone frequencies and population densities in Haiti since the 19th century

NASA Astrophysics Data System (ADS)

Klose, C. D.

2011-12-01

The second edition of the United Nations Global Assessment Report on Disaster Risk Reduction in 2011 outlined that the worldwide physical exposure to tropical cyclones increased by 192 per cent between 1970 and 2010. For the past 160 years, the Republic of Haiti has experienced numerous tropical storms and hurricanes which may have directly effected the country's development path. However, statistical data regarding storm frequencies and population densities in space and time show that the population's exposure in Haiti may have more negatively influenced its development than the actual number of storms and hurricanes. Haitians, in particular, those living in urban areas have been exposed to much higher tropical cyclone hazards than rural areas since the second half of the 20th century. Specifically, more storms made landfall in regions of accelerated migration/urbanization, such as, in departments Ouest, Artibonite, Nord, and Nord-Ouest with Haiti's four largest cities Port-au-Prince, Gonaives, Cap-Haitien and Port-de-Paix.

Sentinel events predicting later unwanted sex among girls: A national survey in Haiti, 2012.

PubMed

Sumner, Steven A; Marcelin, Louis H; Cela, Toni; Mercy, James A; Lea, Veronica; Kress, Howard; Hillis, Susan D

2015-12-01

Sexual violence against children is a significant global public health problem, yet limited studies exist from low-resource settings. In Haiti we conducted the country's first, nationally representative survey focused on childhood violence to help inform the development of a national action plan for violence against children. The Haiti Violence Against Children Survey was a household-level, multistage, cluster survey among youth age 13-24. In this analysis we sought to determine whether sexual violence sentinel events (unwanted sexual touching or unwanted attempted sex) were predictive of later unwanted, completed, penetrative sex in Haiti. We also sought to explore characteristics of sentinel events and help-seeking behavior among Haitian children. Multivariable logistic regression was used to test associations between sentinel events and later unwanted, completed, penetrative sex. Overall, 1,457 females reported on experiences of sexual violence occurring in childhood (before age 18). A sentinel event occurred in 40.4% of females who experienced subsequent unwanted completed sex. Females experiencing a sentinel event were approximately two and a half times more likely to experience later unwanted completed sex (adjusted odds ratio=2.40, p=.004) compared to individuals who did not experience a sentinel event. The mean lag time from first sentinel event to first unwanted completed sex was 2.3 years. Only half (54.6%) of children experiencing a sentinel event told someone about their experience of sexual violence. Among children, sentinel events occur frequently before later acts of completed unwanted sex and may represent a useful point of intervention. Reporting of sexual violence by children in Haiti is low and can be improved to better act on sentinel events. Published by Elsevier Ltd.

[Experience in establishing ophthalmology at the Hôpital Albert Schweitzer (HAS) in Deschapelles, Haiti].

PubMed

Eisenmann, D; Bracher, H R

2007-04-01

Haiti is regarded as the poorest country of the Western hemisphere. The Hôpital Albert Schweitzer (HAS), founded in 1956 by Larimer Melon, is providing medical care to the Artibonite valley, an area in the centre of Haiti with over 400 000 inhabitants. Until 2001, a three-fold population was without eye care in central Haiti. In 2001, Hans Rudolf Bracher, a retired ophthalmologist from Bern, initiated the eye department at HAS and organised an eye examination unit, a microscope and further surgical equipment. Since then, eye care to the population was provided by short-term visits of ophthalmologists, nurses and orthoptists, mainly from switzerland. Additionally, teaching and surgical training was performed at university hospital in Port-au-Price, the only education centre for ophthalmologists in the country. The actual political and security situation complicates visits of western doctors. A development association for the HAS eye department was founded and with its help, an Haitian ophthalmologist is employed in a full-time position. Furthermore, logistic support is provided with drugs and surgical equipment. Today, under difficult circumstances, the eye department is well established as an effective and cost-covering institution at HAS.

75 FR 3476 - Designation of Haiti for Temporary Protected Status

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... Express mail and courier deliveries: USCIS, Attn: Haiti TPS, 2501 S. State Hwy. 121 Business, Suite 400... DEPARTMENT OF HOMELAND SECURITY U.S. Citizenship and Immigration Services [CIS No. 2491-10; DHS..., the Secretary is authorized to designate a foreign state for TPS or parts of such state upon finding...

Letter to the Editor : Rapidly-deployed small tent hospitals: lessons from the earthquake in Haiti.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosen, Y.; Gurman , P.; Verna, E.

2012-06-01

The damage to medical facilities resulting form the January 2010 earthquake in haiti necessitated the establishment of field tent hospitals. Much of the local medical infrastructure was destroyed or limited operationally when the Fast Israel Rescue and Search Team (FIRST) arrived in Haiti shortly after the January 2010 earthquake. The FIRST deployed small tent hospitals in Port-au-Prince and in 11 remote areas outside of the city. Each tent was set up in less than a half hour. The tents were staffed with an orthopedic surgeon, gynecologists, primary care and emergency care physicians, a physician with previous experience in tropical medicine,more » nurses, paramedics, medics, and psychologists. The rapidly deployable and temporary nature of the effort allowed the team to treat and educate, as well as provide supplies for, thousands of refugees throughout Haiti. In addition, a local Haitian physician and his team created a small tent hospital to serve the Petion Refugee Camp and its environs. FIRST personnel also took shifts at this hospital.« less

Community-based participatory research in Little Haiti: challenges and lessons learned.

PubMed

Kobetz, Erin; Menard, Janelle; Diem, Joshua; Barton, Betsy; Blanco, Jenny; Pierre, Larry; Auguste, Pascale D; Etienne, Marie; Brewster, Cheryl

2009-01-01

Community-based participatory research (CBPR) is an effective methodology for developing relevant interventions with socially marginalized communities. However, implementing CBPR methods is challenging for several reasons. This paper presents challenges encountered in the context of an ongoing CBPR initiative in Little Haiti in Miami, Florida, and describes the solutions used to address them. We sought to describe the challenges faced and lessons learned while conducting CBPR in Little Haiti. Community-academic partnerships were created to guide the creation of culturally relevant cancer interventions and research. Historical distrust of research, cultural constructions of health and illness, and literacy issues are key considerations when developing partnerships with Haitian and other marginalized, immigrant communities. Partnerships are fostered over time through demonstrated mutual commitment to improving health and building community capacity. Communities must play an active role throughout the research process to ensure that studies are culturally relevant, and ensuing intervention, sustainable.

The academic health center in complex humanitarian emergencies: lessons learned from the 2010 Haiti earthquake.

PubMed

Babcock, Christine; Theodosis, Christian; Bills, Corey; Kim, Jimin; Kinet, Melodie; Turner, Madeleine; Millis, Michael; Olopade, Olufunmilayo; Olopade, Christopher

2012-11-01

On January 12, 2010, a 7.0-magnitude earthquake struck Haiti. The event disrupted infrastructure and was marked by extreme morbidity and mortality. The global response to the disaster was rapid and immense, comprising multiple actors-including academic health centers (AHCs)-that provided assistance in the field and from home. The authors retrospectively examine the multidisciplinary approach that the University of Chicago Medicine (UCM) applied to postearthquake Haiti, which included the application of institutional structure and strategy, systematic deployment of teams tailored to evolving needs, and the actual response and recovery. The university mobilized significant human and material resources for deployment within 48 hours and sustained the effort for over four months. In partnership with international and local nongovernmental organizations as well as other AHCs, the UCM operated one of the largest and more efficient acute field hospitals in the country. The UCM's efforts in postearthquake Haiti provide insight into the role AHCs can play, including their strengths and limitations, in complex disasters. AHCs can provide necessary intellectual and material resources as well as technical expertise, but the cost and speed required for responding to an emergency, and ongoing domestic responsibilities, may limit the response of a large university and hospital system. The authors describe the strong institutional backing, the detailed predeployment planning and logistical support UCM provided, the engagement of faculty and staff who had previous experience in complex humanitarian emergencies, and the help of volunteers fluent in the local language which, together, made UCM's mission in postearthquake Haiti successful.

"Ayiti Cheri": Cultural Orientation of Early Adolescents in Rural Haiti

ERIC Educational Resources Information Center

Ferguson, Gail M.; Desir, Charlene; Bornstein, Marc H.

2014-01-01

Adolescents are an emerging population in Haiti, particularly after the deadly 2010 earthquake. The steady penetration of U.S. culture into this poor, disaster-prone country begs the question, Do today's adolescents possess a similar fondness for their home country, culture, and traditional family values as did Haitians of old? Or are they more…

Medical equipment donations in Haiti: flaws in the donation process.

PubMed

Dzwonczyk, Roger; Riha, Chris

2012-04-01

The magnitude 7.0 earthquake that struck Haiti on 12 January 2010 devastated the capital city of Port-au-Prince and the surrounding area. The area's hospitals suffered major structural damage and material losses. Project HOPE sought to rebuild the medical equipment and clinical engineering capacity of the country. A team of clinical engineers from the United States of America and Haiti conducted an inventory and assessment of medical equipment at seven public hospitals affected by the earthquake. The team found that only 28% of the equipment was working properly and in use for patient care; another 28% was working, but lay idle for technical reasons; 30% was not working, but repairable; and 14% was beyond repair. The proportion of equipment in each condition category was similar regardless of whether the equipment was present prior to the earthquake or was donated afterwards. This assessment points out the flaws that existed in the medical equipment donation process and reemphasizes the importance of the factors, as delineated by the World Health Organization more than a decade ago, that constitute a complete medical equipment donation.

A Pilot Initiative to Deliver Community-based Psychiatric Services in Rural Haiti After the 2010 Earthquake.

PubMed

Grelotti, David J; Lee, Amy C; Fils-Aimé, Joseph Reginald; Jean, Jacques Solon; Therosmé, Tatiana; Petit-Homme, Handy; Oswald, Catherine M; Raviola, Giuseppe; Eustache, Eddy

2015-01-01

Worldwide, there is a gap between the burden of mental distress and disorder and access to mental health care. This gap is particularly large in low- and middle-income countries (LMICs). After the 2010 earthquake in Haiti, the international health care organizations Partners in Health and Zanmi Lasante worked to expand local mental health services in rural Haiti. The aims of this study are to describe clinical characteristics of the patients served during a pilot project to deliver community-based psychiatric services in rural Haiti and to show how this experience complements the Mental Health Gap Action Programme ("mhGAP"), a tool developed by the World Health Organization to support mental health care delivery by nonspecialists in LMICs. The pilot was conducted in March 2011. A visiting psychiatrist traveled to rural Haiti and paired with local clinicians to evaluate patients and to support quality improvement practices in psychiatric care. Patients received a standard neuropsychiatric evaluation. mhGAP was an important clinical reference. To assess the experience, we conducted a retrospective chart review of outpatient encounters. Sixty-five patients presented with a wide range of common psychiatric, neurologic, and general medical conditions. Forty-nine of these patients (75%) reported primary problems subsumed by an mhGAP module. Fifteen patients (23%) reported headache as their chief complain, a condition that is not currently covered by mhGAP. Surprisingly, only 3 patients (5%), reported earthquake-related distress. Our clinical data reinforce the need for provision of standard psychiatric and neurologic services in LMICs. Such services ought to accompany interventions targeted specifically at disaster-related problems. Clinical situations falling outside existing mhGAP modules inspired the development of supplemental treatment protocols. These observations informed coordinated efforts at Zanmi Lasante to build a sustainable, integrated mental health system

Defense Management: U.S. Southern Command Demonstrates Interagency Collaboration, but Its Haiti Disaster Response Revealed Challenges Conducting a Large Military Operation

DTIC Science & Technology

2010-07-01

Barbados, Belize, Bolivia, Brazil, Chile , Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica...19The international liaisons at SOUTHCOM include representatives from eight countries— Argentina, Brazil, Canada, Chile ...Nongovernmental Participants Agua Viva Alliance for Rabies Control FACE Food for the Poor Haiti Resource Development Foundation Hugs Across America

Presentation, Treatment, and Outcomes of Haitian Women With Breast Cancer in Miami and Haiti: Disparities in Breast Cancer—A Retrospective Cohort Study

PubMed Central

Gomez, Alexandra; DeGennaro, Vincent; George, Sophia H.L.; Reis, Isildinha M.; Santamaria, Estefania; Westin, Gustavo Figueiredo; Gabriel, Dieudina

2017-01-01

Purpose We compared a cohort of Haitian immigrants with residents in Haiti with breast cancer (BC) to evaluate the effects of location on presentation, treatment, and outcomes. Patients and Methods Participants were Haitian women with BC living in Miami who presented to the University of Miami/Jackson Memorial Hospital and women with BC living in Haiti who presented to the Innovating Health International Women’s Cancer Center. The primary outcome was the relationship between location, cancer characteristics, and survival. The secondary objective was to compare our results with data extracted from the SEER database. Cox regression was used to compare survival. Results One hundred two patients from University of Miami/Jackson Memorial Hospital and 94 patients from Innovating Health International were included. The patients in Haiti, compared with the patients in Miami, were younger (mean age, 50.2 v 53.7 years, respectively; P = .042), presented after a longer duration of symptoms (median, 20 v 3 months, respectively; P < .001), had more advanced stage (44.7% v 25.5% with stage III and 27.6% v 18.6% with stage IV BC, respectively), and had more estrogen receptor (ER) –negative tumors (44.9% v 26.5%, respectively; P = .024). The percentage of women who died was 31.9% in Haiti died compared with 17.6% in Miami. Median survival time was 53.7 months for women in Haiti and was not reached in Miami. The risk of death was higher for women in Haiti versus women in Miami (adjusted hazard ratio, 3.09; P = .0024). Conclusion Women with BC in Haiti experience a significantly worse outcome than immigrants in Miami, which seems to be related to a more advanced stage and younger age at diagnosis, more ER-negative tumors, and lack of timely effective treatments. The differences in age and ER status are not a result of access to care and are unexplained. PMID:28831447

Use of Damage Data for Calibration of GMPE's in Haiti

NASA Astrophysics Data System (ADS)

Torres, Y.; Molina, S.; Navarro, M.; Benito, B.

2013-05-01

After the 12 January 2010 earthquake that occurred in the south of Haiti, the Earthquake Engineering Researching Group (GIIS) of the Technical University of Madrid (UPM, Spain) set up a cooperative line with the National Observatory of the Environment and Vulnerability of Haiti (ONEV), under the Ministry of the Environment. Within the frame of that working line, the project SISMO-HAITI was launched to estimate the seismic hazard in the country and the seismic risk in Port-au-Prince, the capital city. It was financed by the UPM. In the frame of the seismic risk study, an approach aimed at calibrating the Ground Motion Prediction Equations (GMPE`s) using damage data, was proposed and applied. This approach is presented here and may be useful in absence of strong motion data. The seismic risk estimation was carried out by following the capacity spectrum method as implemented in the software SELENA (Molina et al., 2010). The method requires two main inputs: classification of the building stock into predominant building typologies and a ground motion prediction equation (GMPE) to estimate the seismic demand. We found six building typologies in the city, and were assigned capacity and fragility curves (damage functions) taken from HAZUS and RISK-UE, which account for their vulnerability. Regarding the GMPE, as there are not relationships developed specifically for Haiti, we decided to use the next four: Boore & Atkinson (2008-2011), Abrahamson & Silva, (2008), Campbell & Bozorgnia (2008), Chiou & Youngs (2008). All of them belong to the Next Generation Attenuation (NGA) models and allow including several parameters to define the seismic scenario, the source and the soil geotechnical characteristics. In this paper we present the results of the GMPE's calibration, a step aimed at figure out which is the most suitable relationship for the study area. We could not use acceleration records, since there were no accelerometers at the moment of the earthquake occurrence. Instead

Orphans and at-risk children in Haiti: vulnerabilities and human rights issues postearthquake.

PubMed

Nicholas, Patrice K; George, Erin K; Raymond, Nadia; Lewis-OʼConnor, Annie; Victoria, Stephanie; Lucien, Sergeline; Peters-Lewis, Angelleen; Hickey, Nancy; Corless, Inge B; Tyer-Viola, Lynda; Davis, Sheila M; Barry, Donna; Marcelin, Naomie; Valcourt, Roodeline

2012-01-01

The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.

Emergency Care Capabilities in North East Haiti: A Cross-sectional Observational Study.

PubMed

De Wulf, Annelies; Aluisio, Adam R; Muhlfelder, Dana; Bloem, Christina

2015-12-01

The North East Department is a resource-limited region of Haiti. Health care is provided by hospitals and community clinics, with no formal Emergency Medical System and undefined emergency services. As a paucity of information exists on available emergency services in the North East Department of Haiti, the objective of this study was to assess systematically the existing emergency care resources in the region. This cross-sectional observational study was carried out at all Ministry of Public Health and Population (MSPP)-affiliated hospitals in the North East Department and all clinics within the Fort Liberté district. A modified version of the World Health Organization (WHO) Tool for Situational Analysis to Assess Emergency and Essential Surgical Care and Generic Essential Emergency Equipment Lists were completed for each facility. Three MSPP hospitals and five clinics were assessed. Among hospitals, all had a designated emergency ward with 24 hour staffing by a medical doctor. All hospitals had electricity with backup generators and access to running water; however, none had potable water. All hospitals had x-ray and ultrasound capabilities. No computed tomography scanners existed in the region. Invasive airway equipment and associated medications were not present consistently in the hospitals' emergency care areas, but they were available in the operating rooms. Pulse oximetry was unavailable uniformly. One hospital had intermittently functioning defibrillation equipment, and two hospitals had epinephrine. Basic supplies for managing obstetrical and traumatic emergencies were available at all hospitals. Surgical services were accessible at two hospitals. No critical care services were available in the region. Clinics varied widely in terms of equipment availability. They uniformly had limited emergency medical equipment. The clinics also had inconsistent access to basic assessment tools (sphygmomanometers 20% and stethoscopes 60%). A protocol for transferring

Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening and treatment of pregnant women in Port-au-Prince, Haiti.

PubMed

Bristow, Claire C; Mathelier, Patricia; Ocheretina, Oksana; Benoit, Daphne; Pape, Jean W; Wynn, Adriane; Klausner, Jeffrey D

2017-10-01

In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi's sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated - 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.

Long-term reductions in mortality among children under age 5 in rural Haiti: effects of a comprehensive health system in an impoverished setting.

PubMed

Perry, Henry; Berggren, Warren; Berggren, Gretchen; Dowell, Duane; Menager, Henri; Bottex, Erve; Dortonne, Jean Richard; Philippe, Francois; Cayemittes, Michel

2007-02-01

Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999. We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison. In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas. HAS's programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.

Who Will be My Brother's Keeper--My First Visit to Haiti

ERIC Educational Resources Information Center

Tinker Sachs, Gertrude

2013-01-01

In this article, the author describes her preparations for the Teaching English to Speakers of Other Languages (TESOL) professional presentations in Haiti. As a cultural worker, (after Paulo Freire), she was very conscious of the need for care in working with "the Other" especially when the Other is known only from second hand…

Dog Ecology and Barriers to Canine Rabies Control in the Republic of Haiti, 2014-2015.

PubMed

Schildecker, S; Millien, M; Blanton, J D; Boone, J; Emery, A; Ludder, F; Fenelon, N; Crowdis, K; Destine, A; Etheart, M; Wallace, R M

2017-10-01

An estimated 59 000 persons die annually of infection with the rabies virus worldwide, and dog bites are responsible for 95% of these deaths. Haiti has the highest rate of animal and human rabies in the Western Hemisphere. This study describes the status of animal welfare, animal vaccination, human bite treatment, and canine morbidity and mortality in Haiti in order to identify barriers to rabies prevention and control. An epidemiologic survey was used for data collection among dog owners during government-sponsored vaccination clinics at fourteen randomly selected sites from July 2014 to April 2015. A total of 2005 surveys were collected and data were analysed using parametric methods. Over 50% of owned dogs were allowed to roam freely, a factor associated with rabies transmission. More than 80% of dog owners reported experiencing barriers to accessing rabies vaccination for their dogs. Nearly one-third of the dog population evaluated in this study died in the year preceding the survey (32%) and 18% of these deaths were clinically consistent with rabies. Dog bites were commonly reported, with more than 3% of the study population bitten within the year preceding the survey. The incidence of canine rabies in Haiti is high and is exacerbated by low access to veterinary care, free-roaming dog populations and substandard animal welfare practices. Programmes to better understand the dog ecology and development of methods to improve access to vaccines are needed. Rabies deaths are at historical lows in the Western Hemisphere, but Haiti and the remaining canine rabies endemic countries still present a significant challenge to the goal of rabies elimination in the region. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Emergency surgical care delivery in post-earthquake Haiti: Partners in Health and Zanmi Lasante experience.

PubMed

McIntyre, Thomas; Hughes, Christopher D; Pauyo, Thierry; Sullivan, Stephen R; Rogers, Selwyn O; Raymonville, Maxi; Meara, John G

2011-04-01

The earthquake that struck Haiti on 12 January 2010 caused significant devastation to both the country and the existing healthcare infrastructure in both urban and rural areas. Most hospital and health care facilities in Port-au-Prince and the surrounding areas were significantly damaged or destroyed. Consequently, large groups of Haitians fled Port-au-Prince for rural areas to seek emergency medical and surgical care. In partnership with the Haitian Ministry of Health, Partners in Health (PIH) and Zanmi Lasante (ZL) have developed and maintained a network of regional and district hospitals in rural Haiti for over twenty-five years. This PIH/ZL system was ideally situated to accommodate the increased need for emergent surgical care in the immediate quake aftermath. The goal of the present study was to provide a cross-sectional assessment of surgical need and care delivery across PIH/ZL facilities after the earthquake in Haiti. We conducted a retrospective review of hospital case logs and operative records over the course of three weeks immediately following the earthquake. Roughly 3,000 patients were seen at PIH/ZL sites by a combination of Haitian and international surgical teams. During that period 513 emergency surgical cases were logged. Other than wound debridement, the most commonly performed procedure was fixation of long bone fractures, which constituted approximately one third of all surgical procedures. There was a significant demand for emergent surgical care after the earthquake in Haiti. The PIH/ZL hospital system played a critical role in addressing this acutely increased burden of surgical disease, and it allowed for large numbers of Haitians to receive needed surgical services. Our experiences reinforce that access to essential surgery is an essential pillar in public health.

Citizen Hydrology and Compressed-Air Hydropower for Rural Electrification in Haiti

NASA Astrophysics Data System (ADS)

Allen, S. M.

2015-12-01

At the present time, only one in eight residents of Haiti has access to electricity. Two recent engineering and statistical innovations have the potential for vastly reducing the cost of installation of hydropower in Haiti and the rest of the developing world. The engineering innovation is that wind, solar and fluvial energy have been used to compress air for generation of electricity for only 20 per megawatt-hour, in contrast to the conventional World Bank practice of funding photovoltaic cells for 156 per megawatt-hour. The installation of hydropower requires a record of stream discharge, which is conventionally obtained by installing a gaging station that automatically monitors gage height (height of the water surface above a fixed datum). An empirical rating curve is then used to convert gage height to stream discharge. The multiple field measurements of gage height and discharge over a wide range of discharge values that are required to develop and maintain a rating curve require a manpower of hydrologic technicians that is prohibitive in remote and impoverished areas of the world. The statistical innovation is that machine learning has been applied to the USGS database of nearly four million simultaneous measurements of gage height and discharge to develop a new classification of rivers so that a rating curve can be developed solely from the stream slope, channel geometry, horizontal and vertical distances to the nearest upstream and downstream confluences, and two pairs of discharge - gage height measurements. The objective of this study is to organize local residents to monitor gage height at ten stream sites in the northern peninsula of Haiti over a one-year period in preparation for installation of hydropower at one of the sites. The necessary baseline discharge measurements and channel surveying are being carried out for conversion of gage height to discharge. Results will be reported at the meeting.

Use of Bead-Based Serologic Assay to Evaluate Chikungunya Virus Epidemic, Haiti.

PubMed

Rogier, Eric W; Moss, Delynn M; Mace, Kimberly E; Chang, Michelle; Jean, Samuel E; Bullard, Stevan M; Lammie, Patrick J; Lemoine, Jean Frantz; Udhayakumar, Venkatachalam

2018-06-01

The index case of chikungunya virus (CHIKV) in Haiti was reported during early 2014; the vector, the pervasive Aedes aegypti mosquito, promoted rapid spread throughout the country. During December 2014-February 2015, we collected blood samples from 4,438 persons at 154 sites (62 urban, 92 rural) throughout Haiti and measured CHIKV IgG by using a multiplex bead assay. Overall CHIKV seroprevalence was 57.9%; differences between rural (mean 44.9%) and urban (mean 78.4%) areas were pronounced. Logistic modeling identified the urban environment as a strong predictor of CHIKV exposure (adjusted odds ratio 3.34, 95% CI 2.38-4.69), and geographic elevation provided a strong negative correlation. We observed no correlation between age and antibody positivity or titer. Our findings demonstrated through serologic testing the recent and rapid dissemination of the arbovirus throughout the country. These results show the utility of serologic data to conduct epidemiologic studies of quickly spreading mosquitoborne arboviruses.

Treating Childhood Malnutrition in Rural Haiti: Program Outcomes and Obstacles.

PubMed

Cuneo, C Nicholas; Dansereau, Emily; Habib, Anand R; Davies, Mary; Ware, Samuel; Kornetsky, Kenneth

Haiti has the worst malnutrition rate in the Western hemisphere. In October 2010, a cholera epidemic erupted and spread rapidly throughout the country, straining Haiti's already fragile health infrastructure across all levels of care. This study reviews data from an outpatient therapeutic feeding program (OTP) for acute childhood malnutrition at a clinic in rural Haiti with a focus on the effect of the 2010 cholera epidemic on program operations. A retrospective chart review was conducted for the complete set of patients who were enrolled in the OTP from its inception in March 2009 through January 2014. A total of 187 charts were retrieved representing 176 unique patients, of whom 5 were currently enrolled in care. At admission, 96 (51.3%) met criteria for severe acute malnutrition, 88 (47.1%) met criteria for moderate acute malnutrition, and 3 (1.6%) did not meet criteria for acute malnutrition. Of the 182 completed charts, 119 (65.4%) reached their target weight (≥-1 weight-for-height z-score) by discharge (ie, were "cured"), 43 (23.6%) defaulted, 11 (6.0%) were discharged prematurely, 8 (4.4%) died, and 1 (0.5%) was hospitalized. A total of 11 patients (6.3%) who were initially admitted relapsed after discharge and were later readmitted. Data from 170 complete records (93.4%) were included in a multivariate logistic regression. Severe (vs moderate) acute malnutrition was negatively associated with likelihood of being cured when controlling for other patient- and care-related factors (OR = 0.261, P = .002). Average cholera burden was negatively correlated with likelihood of OTP treatment cure when controlling for patient- and care-related variables (OR = 0.859, P = .002) but was insignificant when controlling for year. Results from the study have been used to inform a restructuring of the clinic's acute malnutrition program toward a more community-centered model of management, the context and implications of which are discussed in relation to the existing

'My body is mine': Qualitatively exploring agency among internally displaced women participants in a small-group intervention in Leogane, Haiti.

PubMed

Logie, Carmen H; Daniel, CarolAnn

2016-01-01

The 2010 earthquake resulted in the breakdown of Haiti's social, economic and health infrastructure. Over one-quarter of a million people remain internally displaced (ID). ID women experience heightened vulnerability to intimate partner violence (IPV) due to increased poverty and reduced community networks. Scant research has examined experiences of IPV among ID women in post-earthquake Haiti. We conducted a qualitative study to explore the impact of participating in Famn an Aksyon Pou Santé Yo (FASY), a small-group HIV prevention intervention, on ID women's agency in Leogane, Haiti. We conducted four focus groups with ID women, FASY participants (n = 40) and in-depth individual interviews with peer health workers (n = 7). Our study was guided by critical ethnography and paid particular attention to power relations. Findings highlighted multiple forms of IPV (e.g., physical, sexual). Participants discussed processes of intrapersonal (confidence), interpersonal (communication), relational (support) and collective (women's rights) agency. Yet structural factors, including patriarchal gender norms and poverty, silenced IPV discussions and constrained women's agency. Findings suggest that agency among ID women is a multi-level, non-linear and incremental process. To effectively address IPV among ID women in Haiti, interventions should address structural contexts of gender inequity and poverty and concurrently facilitate multi-level processes of agency.

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010-2015.

PubMed

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M

2017-10-01

Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the detection of

Comparative Policy Brief: Status of Intellectual Disabilities in the Republic of Haiti

ERIC Educational Resources Information Center

Jacobson, Erik

2008-01-01

An estimated 800,000 persons have disabilities in Haiti, but there are no data that refer specifically to those with intellectual disabilities. Traditional fears and stigma about disability are widespread. While the constitution supports the idea that people with disabilities should have autonomy and education, there are no laws to mandate…

The Binational Schools: A Planning Base For Schools in Colombia and Haiti.

ERIC Educational Resources Information Center

Orr, Paul G.; Seaquist, Robert G.

This publication contains descriptive information on a group of seven American-type schools (N-12) in Colombia and Haiti. Chapter 1 establishes the historical context in an overview of the American school abroad, especially in Latin America. Included is discussion of the types, characteristics, origins, roles, and functions of these…

Evaluation of the national tuberculosis surveillance program in Haiti

PubMed Central

Salyer, S. J.; Fitter, D. L.; Milo, R.; Blanton, C.; Ho, J. L.; Geffrard, H.; Morose, W.; Marston, B. J.

2015-01-01

OBJECTIVE To assess the quality of tuberculosis (TB) surveillance in Haiti, including whether underreporting from facilities to the national level contributes to low national case registration. METHODS We collected 2010 and 2012 TB case totals, reviewed laboratory registries, and abstracted individual TB case reports from 32 of 263 anti-tuberculosis treatment facilities randomly selected after stratification/weighting toward higher-volume facilities. We compared site results to national databases maintained by a non-governmental organization partner (International Child Care [ICC]) for 2010 and 2012, and the National TB Program (Programme National de Lutte contre la Tuberculose, PNLT) for 2012 only. RESULTS Case registries were available at 30/32 facilities for 2010 and all 32 for 2012. Totals of 3711 (2010) and 4143 (2012) cases were reported at the facilities. Case totals per site were higher in site registries than in the national databases by 361 (9.7%) (ICC 2010), 28 (0.8%) (ICC 2012), and 31 (0.8%) cases (PNLT 2012). Of abstracted individual cases, respectively 11.8% and 6.8% were not recorded in national databases for 2010 (n = 323) and 2012 (n = 351). CONCLUSIONS The evaluation demonstrated an improvement in reporting registered TB cases to the PNLT in Haiti between 2010 and 2012. Further improvement in case notification will require enhanced case detection and diagnosis. PMID:26260822

Strengthening National Disease Surveillance and Response-Haiti, 2010-2015.

PubMed

Juin, Stanley; Schaad, Nicolas; Lafontant, Donald; Joseph, Gerard A; Barzilay, Ezra; Boncy, Jacques; Barrais, Robert; Louis, Frantz Jean; Jean Charles, Nadia Lapierre; Corvil, Salomon; Barthelemy, Nickolsno; Dismer, Amber; Pierre, Jean Samuel; Archer, Roodly W; Antoine, Mayer; Marston, Barbara; Katz, Mark; Dely, Patrick; Adrien, Paul; Fitter, David L; Lowrance, David; Patel, Roopal

2017-10-01

Haiti's health system has faced many challenges over the years, with competing health priorities in the context of chronic financial and human resource limitations. As a result, the existing notifiable disease surveillance system was unable to provide the most basic epidemiologic data for public health decision-making and action. In the wake of the January 2010 earthquake, the Haitian Ministry of Public Health and Population collaborated with the U.S. Centers for Disease Control and Prevention, the Pan American Health Organization, and other local and international partners to implement a functional national surveillance system. More than 7 years later, it is important to take the opportunity to reflect on progress made on surveillance and response in Haiti, including disease detection, reporting, outbreak investigation, and response. The national epidemiologic surveillance network that started with 51 sites in 2010 has been expanded to 357 sites as of December 2015. Disease outbreaks identified via the surveillance system, or other surveillance approaches, are investigated by epidemiologists trained by the Ministry of Health's Field Epidemiology Training Program. Other related surveillance modules have been developed on the same model and electronic platform, allowing the country to document the impact of interventions, track progress, and monitor health problems. Sustainability remains the greatest challenge since most of the funding for surveillance come from external sources.

Haiti: Two Decades of Intervention and Very Little to Show

DTIC Science & Technology

2012-05-17

the period 1994 to 2010, from Operation Uphold Democracy to the Leogane earthquake, with the hope that the research would help improve US policy or...while the guidance given to JTF-180 throughout the planning process provided the strategic aims. UN Security Council Resolutions beginning with...the intervention. If the objectives of the intervention did not include an attempt to improve those conditions in Haiti, then the objectives were

Haiti and the Earthquake: Examining the Experience of Psychological Stress and Trauma

ERIC Educational Resources Information Center

Risler, Ed; Kintzle, Sara; Nackerud, Larry

2015-01-01

For approximately 35 seconds on January 10, 2010, an earthquake measuring 7.0 on the Richter scale struck the small Caribbean nation of Haiti. This research used a preexperimental one-shot posttest to examine the incidence of posttraumatic stress disorder (PTSD) and associated trauma symptomatology from the earthquake experienced by a sample of…

Rapid Development and Use of a Nationwide Training Program for Cholera Management, Haiti, 2010

PubMed Central

Lynch, Michael; Lambert, Yves; Sobel, Jeremy; Domerçant, Jean W.; Khan, Azharul

2011-01-01

When epidemic cholera appeared in Haiti in October 2010, the medical community there had virtually no experience with the disease and needed rapid training as the epidemic spread throughout the country. We developed a set of training materials specific to Haiti and launched a cascading training effort. Through a training-of-trainers course in November 14–15, 2010, and department-level training conducted in French and Creole over the following 3 weeks, 521 persons were trained and equipped to further train staff at the institutions where they worked. After the training, the hospitalized cholera patients’ case-fatality rate dropped from 4% to <2% by mid-December and was <1% by January 2011. Continuing in-service training, monitoring and evaluation, and integration of cholera management into regular clinical training will help sustain this success. PMID:22099112

Impact of performance-based financing on primary health care services in Haiti.

PubMed

Zeng, Wu; Cros, Marion; Wright, Katherine D; Shepard, Donald S

2013-09-01

To strengthen Haiti's primary health care (PHC) system, the country first piloted performance-based financing (PBF) in 1999 and subsequently expanded the approach to most internationally funded non-government organizations. PBF complements support (training and technical assistance). This study evaluates (a) the separate impact of PBF and international support on PHC's service delivery; (b) the combined impact of PBF and technical assistance on PHC's service delivery; and (c) the costs of PBF implementation in Haiti. To minimize the risk of facilities neglecting potential non-incentivized services, the incentivized indicators were randomly chosen at the end of each year. We obtained quantities of key services from four departments for 217 health centres (15 with PBF and 202 without) from 2008 through 2010, computed quarterly growth rates and analysed the results using a difference-in-differences approach by comparing the growth of incentivized and non-incentivized services between PBF and non-PBF facilities. To interpret the statistical analyses, we also interviewed staff in four facilities. Whereas international support added 39% to base costs of PHC, incentive payments added only 6%. Support alone increased the quantities of PHC services over 3 years by 35% (2.7%/quarter). However, support plus incentives increased these amounts by 87% over 3 years (5.7%/quarter) compared with facilities with neither input. Incentives alone was associated with a net 39% increase over this period, and more than doubled the growth of services (P < 0.05). Interview findings found no adverse impacts and, in fact, indicated beneficial impacts on quality. Incentives proved to be a relatively inexpensive, well accepted and very effective complement to support, suggesting that a small amount of money, strategically used, can substantially improve PHC. Haiti's experience, after more than a decade of use, indicates that incentives are an effective tool to strengthen PHC.

Rain Check Application: Mobile tool to monitor rainfall in remote parts of Haiti

NASA Astrophysics Data System (ADS)

Huang, X.; Baird, J.; Chiu, M. T.; Morelli, R.; de Lanerolle, T. R.; Gourley, J. R.

2011-12-01

Rainfall observations performed uniformly and continuously over a period of time are valuable inputs in developing climate models and predicting events such as floods and droughts. Rain-Check is a mobile application developed in Google App Inventor Platform, for android based smart phones, to allow field researchers to monitor various rain gauges distributed though out remote regions of Haiti and send daily readings via SMS messages for further analysis and long term trending. Rainfall rate and quantity interact with many other factors to influence erosion, vegetative cover, groundwater recharge, stream water chemistry and runoff into streams impacting agriculture and livestock. Rainfall observation from various sites is especially significant in Haiti with over 80% of the country is mountainous terrain. Data sets from global models and limited number of ground stations do not capture the fine-scale rainfall patterns necessary to describe local climate. Placement and reading of rain gauges are critical to accurate measurement of rainfall.

Sexual Violence and Reproductive Health among Youth in Port-au-Prince, Haiti

PubMed Central

Gómez, Anu Manchikanti; Speizer, Ilene S.; Beauvais, Harry

2013-01-01

We examine sexual violence and reproductive health outcomes among sexually experienced youth in Port-au-Prince, Haiti, using the Priorities for Local AIDS Control methodology to identify participants in locations where sexual partnerships are formed. Sexual violence is common and is significantly associated with condom use, pregnancy experience and recent STI symptoms. PMID:19380102

High-resolution spatial analysis of cholera patients reported in Artibonite department, Haiti in 2010-2011.

PubMed

Allan, Maya; Grandesso, Francesco; Pierre, Ronald; Magloire, Roc; Coldiron, Matthew; Martinez-Pino, Isabel; Goffeau, Thierry; Gitenet, Romain; François, Gwenola; Olson, David; Porten, Klaudia; Luquero, Francisco J

2016-03-01

Cholera is caused by Vibrio cholerae, and is transmitted through fecal-oral contact. Infection occurs after the ingestion of the bacteria and is usually asymptomatic. In a minority of cases, it causes acute diarrhea and vomiting, which can lead to potentially fatal severe dehydration, especially in the absence of appropriate medical care. Immunity occurs after infection and typically lasts 6-36 months. Cholera is responsible for outbreaks in many African and Asian developing countries, and caused localised and episodic epidemics in South America until the early 1990s. Haiti, despite its low socioeconomic status and poor sanitation, had never reported cholera before the recent outbreak that started in October 2010, with over 720,000 cases and over 8700 deaths (Case fatality rate: 1.2%) through 8 december 2014. So far, this outbreak has seen 3 epidemic peaks, and it is expected that cholera will remain in Haiti for some time. To trace the path of the early epidemic and to identify hot spots and potential transmission hubs during peaks, we examined the spatial distribution of cholera patients during the first two peaks in Artibonite, the second-most populous department of Haiti. We extracted the geographic origin of 84,000 patients treated in local health facilities between October 2010 and December 2011 and mapped these addresses to 63 rural communal sections and 9 urban cities. Spatial and cluster analysis showed that during the first peak, cholera spread along the Artibonite River and the main roads, and sub-communal attack rates ranged from 0.1% to 10.7%. During the second peak, remote mountain areas were most affected, although sometimes to very different degrees even in closely neighboring locations. Sub-communal attack rates during the second peak ranged from 0.2% to 13.7%. The relative risks at the sub-communal level during the second phase showed an inverse pattern compared to the first phase. These findings demonstrate the value of high-resolution mapping

Cholera Vaccination Campaign Contributes to Improved Knowledge Regarding Cholera and Improved Practice Relevant to Waterborne Disease in Rural Haiti

PubMed Central

Aibana, Omowunmi; Franke, Molly; Teng, Jessica; Hilaire, Johanne; Raymond, Max; Ivers, Louise C.

2013-01-01

Background Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti. Methodology/Principal Findings We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May–June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52–2.40), preventive methods (OR 1.83; 95% CI 1.46–2.30), and water treatment modalities (OR 2.75; 95% CI 2.16–3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28–2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03–1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14–1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35–4.51). Conclusion An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti. PMID:24278498

Cholera vaccination campaign contributes to improved knowledge regarding cholera and improved practice relevant to waterborne disease in rural Haiti.

PubMed

Aibana, Omowunmi; Franke, Molly F; Franke, Molly; Teng, Jessica E; Teng, Jessica; Hilaire, Johanne; Raymond, Max; Ivers, Louise C

2013-11-01

Haiti's cholera epidemic has been devastating partly due to underlying weak infrastructure and limited clean water and sanitation. A comprehensive approach to cholera control is crucial, yet some have argued that oral cholera vaccination (OCV) might result in reduced hygiene practice among recipients. We evaluated the impact of an OCV campaign on knowledge and health practice in rural Haiti. We administered baseline surveys on knowledge and practice relevant to cholera and waterborne disease to every 10th household during a census in rural Haiti in February 2012 (N = 811). An OCV campaign occurred from May-June 2012 after which we administered identical surveys to 518 households randomly chosen from the same region in September 2012. We compared responses pre- and post-OCV campaign. Post-vaccination, there was improved knowledge with significant increase in percentage of respondents with ≥ 3 correct responses on cholera transmission mechanisms (odds ratio[OR] 1.91; 95% confidence interval[CI] 1.52-2.40), preventive methods (OR 1.83; 95% CI 1.46-2.30), and water treatment modalities (OR 2.75; 95% CI 2.16-3.50). Relative to pre-vaccination, participants were more likely post-OCV to report always treating water (OR 1.62; 95% CI 1.28-2.05). Respondents were also more likely to report hand washing with soap and water >4 times daily post-vaccine (OR 1.30; 95% CI 1.03-1.64). Knowledge of treating water as a cholera prevention measure was associated with practice of always treating water (OR 1.47; 95% CI 1.14-1.89). Post-vaccination, knowledge was associated with frequent hand washing (OR 2.47; 95% CI 1.35-4.51). An OCV campaign in rural Haiti was associated with significant improvement in cholera knowledge and practices related to waterborne disease. OCV can be part of comprehensive cholera control and reinforce, not detract from, other control efforts in Haiti.

Partnering for impact: Integrated transmission assessment surveys for lymphatic filariasis, soil transmitted helminths and malaria in Haiti.

PubMed

Knipes, Alaine Kathryn; Lemoine, Jean Frantz; Monestime, Franck; Fayette, Carl R; Direny, Abdel N; Desir, Luccene; Beau de Rochars, Valery E; Streit, Thomas G; Renneker, Kristen; Chu, Brian K; Chang, Michelle A; Mace, Kimberly E; Won, Kimberly Y; Lammie, Patrick J

2017-02-01

Since 2001, Haiti's National Program for the Elimination of Lymphatic Filariasis (NPELF) has worked to reduce the transmission of lymphatic filariasis (LF) through annual mass drug administration (MDA) with diethylcarbamazine and albendazole. The NPELF reached full national coverage with MDA for LF in 2012, and by 2014, a total of 14 evaluation units (48 communes) had met WHO eligibility criteria to conduct LF transmission assessment surveys (TAS) to determine whether prevalence had been reduced to below a threshold, such that transmission is assumed to be no longer sustainable. Haiti is also endemic for malaria and many communities suffer a high burden of soil transmitted helminths (STH). Heeding the call from WHO for integration of neglected tropical diseases (NTD) activities, Haiti's NPELF worked with the national malaria control program (NMCP) and with partners to develop an integrated TAS (LF-STH-malaria) to include assessments for malaria and STH. The aim of this study was to evaluate the feasibility of using TAS surveys for LF as a platform to collect information about STH and malaria. Between November 2014 and June 2015, TAS were conducted in 14 evaluation units (EUs) including 1 TAS (LF-only), 1 TAS-STH-malaria, and 12 TAS-malaria, with a total of 16,655 children tested for LF, 14,795 tested for malaria, and 298 tested for STH. In all, 12 of the 14 EUs passed the LF TAS, allowing the program to stop MDA for LF in 44 communes. The EU where children were also tested for STH will require annual school-based treatment with albendazole to maintain reduced STH levels. Finally, only 12 of 14,795 children tested positive for malaria by RDT in 38 communes. Haiti's 2014-2015 Integrated TAS surveys provide evidence of the feasibility of using the LF TAS as a platform for integration of assessments for STH and or malaria.

Maritime security report. April 1997 [Maritime smuggling of drugs and contraband goods through Haiti adversely impacting legitimate commerce and development; Partnering : a key to growing challenges confronting maritime security

DOT National Transportation Integrated Search

1997-04-01

Haiti is a significant transshipment conduit for South American cocaine destined for the United States. This smuggling is facilitated by Haitis system of seaports which remain largely unmonitored. Smuggling and trafficking contraband merchandise aver...

Marginal inherited structures impact on the oblique convergent N American Plate/ Central Caribbean plate-boundary in the Northern Caribbean. The tectonic evolution since Miocene times based on Haiti data acquired onshore and offshore since 2012- a step toward an ADP Drilling Proposal (Haiti-DRILL).

NASA Astrophysics Data System (ADS)

Ellouz, N.; Hamon, Y.; Deschamps, R.; Battani, A.; Wessels, R.; Boisson, D.; Prepetit, C.; Momplaisir, R.

2017-12-01

Since Early Paleogene times, the North Caribbean plate is colliding obliquely with the south continental part of the old N. American Margins, which is represented by various segments from West to East, inherited from Jurassic times. Location, amount of displacement, rotation and the structural deformation of these margin segments, resulting from the dislocation of the continental N American margin, are not clearly yet established. At present, the plate limits are marked either by two left lateral faults west and inside Haiti (OSF in the North and EPGF in the South), oblique collision front (further west in Cuba), oblique subducted segments (to the East, Porto-Rico). From our recent works operated both offshore (Haiti-SIS and Haiti-BGF surveys 2012-2015) and onshore (field campaigns 2013-2017) in Haitian zone, the position of the present-day and paleo major limits have been redefined. These paleolimits have been reconstructed up to early Miocene times, based on: restoration of regional structural cross-sections, sedimentology and on paleoenvironement studies. In a preliminary way, we analyzed the complexity of the tectonic heritage with possible nature, heterogeneity of the crustal fragments and associated margins close to Haiti (age, structure, environment, location of the dislocated blocks through times) which profoundly impact the partitioning of the deformation along this complex transformed margin. The change in the structure wavelength, decollement level variations are primary constraints in the restoration of the main units and do impose a deep connection along specific segments either related to strike-slip or to splay faults. The asymmetry on the repartition of the fault activity tend to prove that the past motion related to "EPGF transfer zone" is mainly partitioned in Haiti to the North of the present-day EPGF position. At present, these results are still coherent with the distribution of the aftershoks registered after 2010, and with the present

Phenotypic Analysis Reveals that the 2010 Haiti Cholera Epidemic Is Linked to a Hypervirulent Strain

PubMed Central

Jones, Christopher J.; Wong, Jennifer; Queen, Jessica; Agarwal, Shivani; Yildiz, Fitnat H.

2016-01-01

Vibrio cholerae O1 El Tor strains have been responsible for pandemic cholera since 1961. These strains have evolved over time, spreading globally in three separate waves. Wave 3 is caused by altered El Tor (AET) variant strains, which include the strain with the signature ctxB7 allele that was introduced in 2010 into Haiti, where it caused a devastating epidemic. In this study, we used phenotypic analysis to compare an early isolate from the Haiti epidemic to wave 1 El Tor isolates commonly used for research. It is demonstrated that the Haiti isolate has increased production of cholera toxin (CT) and hemolysin, increased motility, and a reduced ability to form biofilms. This strain also outcompetes common wave 1 El Tor isolates for colonization of infant mice, indicating that it has increased virulence. Monitoring of CT production and motility in additional wave 3 isolates revealed that this phenotypic variation likely evolved over time rather than in a single genetic event. Analysis of available whole-genome sequences and phylogenetic analyses suggested that increased virulence arose from positive selection for mutations found in known and putative regulatory genes, including hns and vieA, diguanylate cyclase genes, and genes belonging to the lysR and gntR regulatory families. Overall, the studies presented here revealed that V. cholerae virulence potential can evolve and that the currently prevalent wave 3 AET strains are both phenotypically distinct from and more virulent than many El Tor isolates. PMID:27297393

Reflections on Serving Remote Mountain Communities: Mobile Hospitals and Women's and Children's Health Care in Northern Haiti.

PubMed

Chierici, Rose-Marie; Voltaire, Thony Michelet

2016-12-01

In 2003 Alyans Sante Borgne's (ASB) conducted the first week-long mobile hospital in Molas, a poor mountain community a 10-h walk from the main hospital in the town of Borgne in North Haiti. ASB is a partnership between Haiti Outreach-Pwoje Espwa (H.O.P.E.), a US-based NGO, and Haiti's Ministry of Health. The paper reflects on this first experience and the evolution of an indigenous model of health care delivery, Sante Nan Lakou (SNL)/Health at the Extended Family Level, a model that prioritizes the needs of patients over those of the institution. It highlights the challenges of providing quality care to a much neglected segment of our population and documents the impact of this event for the community and for ASB. Lessons learned during that week shaped ASB's response to the root causes of women and children's poor health in the commune of Borgne. The response is articulated in a holistic grassroots program called Sante/Health, Edikasyon/Education, Ekonomi/Economy for Fanm/Women (SEE Fanm). SEE Fanm is a constellation of programs and initiatives that together brings quality care to women and seeks to empower them to take charge of their health and wellbeing and, by extension, that of their families and communities.

Lessons Learned during Public Health Response to Cholera Epidemic in Haiti and the Dominican Republic

PubMed Central

Tappero, Jordan W.

2011-01-01

After epidemic cholera emerged in Haiti in October 2010, the disease spread rapidly in a country devastated by an earthquake earlier that year, in a population with a high proportion of infant deaths, poor nutrition, and frequent infectious diseases such as HIV infection, tuberculosis, and malaria. Many nations, multinational agencies, and nongovernmental organizations rapidly mobilized to assist Haiti. The US government provided emergency response through the Office of Foreign Disaster Assistance of the US Agency for International Development and the Centers for Disease Control and Prevention. This report summarizes the participation by the Centers and its partners. The efforts needed to reduce the spread of the epidemic and prevent deaths highlight the need for safe drinking water and basic medical care in such difficult circumstances and the need for rebuilding water, sanitation, and public health systems to prevent future epidemics. PMID:22099111

Rebuilding Haiti's Educational Access: A Phenomenological Study of Technology Use in Education Delivery

ERIC Educational Resources Information Center

Sandiford, Gladwyn A.

2013-01-01

There is a lack of access to technology blended with face-to-face instruction and learning in Haiti. Despite this lack of access, some Haitian college students have nevertheless leveraged technology to overcome the obstacles of poverty and obtain a higher education. This phenomenological study explored the lived experiences of 20 adult…

Is there a risk of filarial infection during long-term missions in Haiti?

PubMed

Weitzel, Thomas; Rosas, Reinaldo; Fica, Alberto; Dabanch, Jeannette; Polanco, Myriam; Egaña, Alicia; Triantafilo, Vjera; Pfarr, Kenneth; Hoerauf, Achim; Reiter-Owona, Ingrid

2016-01-01

Haiti has the highest prevalence of lymphatic filariasis (Wuchereria bancrofti) in the Western Hemisphere. Still, the risk of filarial infection for long-term visitors such as humanitarian aid workers or military personnel is uncertain. The presented study analyzed the exposure to W. bancrofti in Chilean participants of the UN Stabilization Mission in Haiti (MINUSTAH) in 2011. Blood samples collected from 531 participants were screened for antifilarial antibodies by IgG ELISA, and, if positive, analyzed by immunofluorescence assay (IFA), IgG4 ELISA, Real-Time PCR, and circulating filarial antigen (CFA) card test. ELISA screening was positive in 10 cases. Seroconversion occurred in only two cases (0.38%) based on ELISA values determined in samples taken before and after deployment. Positive IgG ELISA values could not be confirmed by IFA and IgG4 ELISA. Real-Time PCR and CFA testing did not reveal the presence of filaria. Our data indicate that in the examined cohort of MINUSTAH participants in 2011, the risk of filarial exposure or infection was low. Copyright © 2015 Elsevier Ltd. All rights reserved.

Menstrual Education and Personal Hygiene Supplies to Empower Young Women in Haiti.

PubMed

Coker-Bolt, Patricia; Jansson, Annika; Bigg, Sherridan; Hammond, Elizabeth; Hudson, Harmony; Hunkler, Sarah; Kitch, Jana; Richardson, Heather; Tiedemann, Erica; O'Flynn, Janet; Laurent, Marie Dominque

2017-10-01

Recent studies report that Haitian women are concerned about unmet women's health issues. The Days for Girls (DfG) International program features women's health education and personal hygiene kits to ensure women understand the process of menstruation and sanitary hygiene practices. The aim was to train Haitian seamstresses to produce the DfG kits during an in-country workshop and investigate the perceived benefit of the DfG program in young women who used the DfG kits. Posttest only design was used to measure the effectiveness of DfG workshop and postsurvey to study perception of women using DfG kits. It was found that the workshop participants demonstrated an understanding of the DfG program (90% average). Forty-four young women (89.8%) who used the DfG hygiene kits for 2 months agreed that there is a need for feminine hygiene programs in Haiti and that the kits were easy to use and clean (97.1% and 92.1%, respectively). The DfG program could provide a cost-effective feminine hygiene program for Haiti and decrease waste from traditional hygiene products.

USGS-WHOI-DPRI Coulomb Stress-Transfer Model for the January 12, 2010, MW=7.0 Haiti Earthquake

USGS Publications Warehouse

Lin, Jian; Stein, Ross S.; Sevilgen, Volkan; Toda, Shinji

2010-01-01

Using calculated stress changes to faults surrounding the January 12, 2010, rupture on the Enriquillo Fault, and the current (January 12 to 26, 2010) aftershock productivity, scientists from the U.S. Geological Survey (USGS), Woods Hole Oceanographic Institution (WHOI), and Disaster Prevention Research Institute, Kyoto University (DPRI) have made rough estimates of the chance of a magnitude (Mw)=7 earthquake occurring during January 27 to February 22, 2010, in Haiti. The probability of such a quake on the Port-au-Prince section of the Enriquillo Fault is about 2 percent, and the probability for the section to the west of the January 12, 2010, rupture is about 1 percent. The stress changes on the Septentrional Fault in northern Haiti are much smaller, although positive.

Teacher Incentive Systems, Final Report. Policy Research Initiative: Haiti, Liberia, Somalia, Yemen Arab Republic.

ERIC Educational Resources Information Center

Kemmerer, Frances; Thiagarajan, Sivasailam

Findings of a study that examined the implementation of a teacher incentives initiative in four countries--Haiti, Liberia, Somalia, and Yemen--are presented in this paper. The countries are participating in a 10-year initiative founded in 1984, Improving the Efficiency of Educational Systems (IEES). Methodology involved interviews with…

Haiti’s Downward Spiral: Causes, Consequences, and the Way Ahead

DTIC Science & Technology

2011-05-04

Salvador, and Honduras. Known as the “cocaine corridor” to the United States via Mexico , these states are an increasing concern for U.S. national...corridor” to the United States via Mexico , these states are an increasing concern for U.S. national security and therefore deserve SOUTHCOM’s full...water wells took on increased urgency after Haiti experienced a cholera outbreak in October 2010 that infected over 250,000 people, killing more than

High depth, whole-genome sequencing of cholera isolates from Haiti and the Dominican Republic.

PubMed

Sealfon, Rachel; Gire, Stephen; Ellis, Crystal; Calderwood, Stephen; Qadri, Firdausi; Hensley, Lisa; Kellis, Manolis; Ryan, Edward T; LaRocque, Regina C; Harris, Jason B; Sabeti, Pardis C

2012-09-11

Whole-genome sequencing is an important tool for understanding microbial evolution and identifying the emergence of functionally important variants over the course of epidemics. In October 2010, a severe cholera epidemic began in Haiti, with additional cases identified in the neighboring Dominican Republic. We used whole-genome approaches to sequence four Vibrio cholerae isolates from Haiti and the Dominican Republic and three additional V. cholerae isolates to a high depth of coverage (>2000x); four of the seven isolates were previously sequenced. Using these sequence data, we examined the effect of depth of coverage and sequencing platform on genome assembly and identification of sequence variants. We found that 50x coverage is sufficient to construct a whole-genome assembly and to accurately call most variants from 100 base pair paired-end sequencing reads. Phylogenetic analysis between the newly sequenced and thirty-three previously sequenced V. cholerae isolates indicates that the Haitian and Dominican Republic isolates are closest to strains from South Asia. The Haitian and Dominican Republic isolates form a tight cluster, with only four variants unique to individual isolates. These variants are located in the CTX region, the SXT region, and the core genome. Of the 126 mutations identified that separate the Haiti-Dominican Republic cluster from the V. cholerae reference strain (N16961), 73 are non-synonymous changes, and a number of these changes cluster in specific genes and pathways. Sequence variant analyses of V. cholerae isolates, including multiple isolates from the Haitian outbreak, identify coverage-specific and technology-specific effects on variant detection, and provide insight into genomic change and functional evolution during an epidemic.

Documentation for Initial Seismic Hazard Maps for Haiti

USGS Publications Warehouse

Frankel, Arthur; Harmsen, Stephen; Mueller, Charles; Calais, Eric; Haase, Jennifer

2010-01-01

In response to the urgent need for earthquake-hazard information after the tragic disaster caused by the moment magnitude (M) 7.0 January 12, 2010, earthquake, we have constructed initial probabilistic seismic hazard maps for Haiti. These maps are based on the current information we have on fault slip rates and historical and instrumental seismicity. These initial maps will be revised and improved as more data become available. In the short term, more extensive logic trees will be developed to better capture the uncertainty in key parameters. In the longer term, we will incorporate new information on fault parameters and previous large earthquakes obtained from geologic fieldwork. These seismic hazard maps are important for the management of the current crisis and the development of building codes and standards for the rebuilding effort. The boundary between the Caribbean and North American Plates in the Hispaniola region is a complex zone of deformation. The highly oblique ~20 mm/yr convergence between the two plates (DeMets and others, 2000) is partitioned between subduction zones off of the northern and southeastern coasts of Hispaniola and strike-slip faults that transect the northern and southern portions of the island. There are also thrust faults within the island that reflect the compressional component of motion caused by the geometry of the plate boundary. We follow the general methodology developed for the 1996 U.S. national seismic hazard maps and also as implemented in the 2002 and 2008 updates. This procedure consists of adding the seismic hazard calculated from crustal faults, subduction zones, and spatially smoothed seismicity for shallow earthquakes and Wadati-Benioff-zone earthquakes. Each one of these source classes will be described below. The lack of information on faults in Haiti requires many assumptions to be made. These assumptions will need to be revisited and reevaluated as more fieldwork and research are accomplished. We made two sets of

Predictability of population displacement after the 2010 Haiti earthquake

PubMed Central

Lu, Xin; Bengtsson, Linus; Holme, Petter

2012-01-01

Most severe disasters cause large population movements. These movements make it difficult for relief organizations to efficiently reach people in need. Understanding and predicting the locations of affected people during disasters is key to effective humanitarian relief operations and to long-term societal reconstruction. We collaborated with the largest mobile phone operator in Haiti (Digicel) and analyzed the movements of 1.9 million mobile phone users during the period from 42 d before, to 341 d after the devastating Haiti earthquake of January 12, 2010. Nineteen days after the earthquake, population movements had caused the population of the capital Port-au-Prince to decrease by an estimated 23%. Both the travel distances and size of people’s movement trajectories grew after the earthquake. These findings, in combination with the disorder that was present after the disaster, suggest that people’s movements would have become less predictable. Instead, the predictability of people’s trajectories remained high and even increased slightly during the three-month period after the earthquake. Moreover, the destinations of people who left the capital during the first three weeks after the earthquake was highly correlated with their mobility patterns during normal times, and specifically with the locations in which people had significant social bonds. For the people who left Port-au-Prince, the duration of their stay outside the city, as well as the time for their return, all followed a skewed, fat-tailed distribution. The findings suggest that population movements during disasters may be significantly more predictable than previously thought. PMID:22711804

Energy Justice and the Stakeholders Involved: A Case Study of Solar Power in Rural Haiti

NASA Astrophysics Data System (ADS)

Romulus, Elijah Rey Asse

This paper explores and analyzes energy justice and the stakeholders involved. Energy insecurity, specifically the lack of access to electricity effects over 1.3 billion people worldwide and energy justice is a way to address it. This paper is supported by a case study with data collected in the southern rural regions of Haiti regarding energy justice communities. Three cities were studied: Les Cayes, Anse-a-Veau, and Les Anglais. It examines how solar businesses can aid energy justice communities seeking access to electricity. Stakeholders such as the communities themselves, solar businesses, and nonprofits in the region are studied and analyzed. The paper concludes solar businesses are helping said communities but needs participation from other stakeholders to be successful. Finally, there are five recommendations to build capacity, develop infrastructure in the region, explore the possibility of solar cooperatives, strengthen the solar economy in Haiti, and demand reparations.

Disability in post-earthquake Haiti: prevalence and inequality in access to services.

PubMed

Danquah, Lisa; Polack, Sarah; Brus, Aude; Mactaggart, Islay; Houdon, Claire Perrin; Senia, Patrick; Gallien, Pierre; Kuper, Hannah

2015-01-01

To assess the prevalence of disability and service needs in post-earthquake Haiti, and to compare the inclusion and living conditions of people with disabilities to those without disabilities. A population-based prevalence survey of disability was undertaken in 2012 in Port-au-Prince region, which was at the centre of the earthquake in 2010. Sixty clusters of 50 people aged 5 + years were selected with probability proportionate to size sampling and screened for disability (Washington Group short set questionnaire). A case-control study was undertaken, nested within the survey, matching cases to controls by age, gender and cluster. There was additional case finding to identify further children with disabilities. Information was collected on: socioeconomic status, education, livelihood, health, activities, participation and barriers. The prevalence of disability was 4.1% (3.4-4.7%) across 3132 eligible individuals. The earthquake was the second leading cause of disability. Disability was more common with increasing age, but unrelated to poverty. Large gaps existed in access of services for people with disabilities. Adults with disabilities were less likely to be literate or work and more likely to visit health services than adults without disabilities. Children with disabilities were less likely to be currently enrolled at school compared to controls. Children and adults with disabilities reported more activity limitations and participation restriction. Further focus is needed to improve inclusion of people with disabilities in post-earthquake Haiti to ensure that their rights are fulfilled. Almost one in six households in this region of Haiti included a person with a disability, and the earthquake was the second leading cause of disability. Fewer than half of people who reported needing medical rehabilitation had received this service. The leading reported barriers to the uptake of health services included financial constraints (50%) and difficulties with

The Transmission Dynamics and Control of Cholera in Haiti: An Epidemic Model

PubMed Central

Andrews, Jason R.; Basu, Sanjay

2011-01-01

Background Haiti is experiencing a cholera epidemic. Official epidemic projections, to date, have failed to incorporate existing disease trends or patterns of transmission, while proposed interventions have been debated without comparative estimates of their impact. Methods We designed mathematical models of cholera transmission and fit them to Haiti’s provincial incidence data. We then simulated future epidemic trajectories to estimate the impact of clean water, vaccination and enhanced antibiotic distribution programs. Findings The natural dynamics of cholera are expected to produce a prevalence decline by mid-January 2011. Between March and December 2011, we project 779,000 (95% CI: 599,000–914,000) cases and 11,100 (95% CI: 7,300–17,400) deaths from cholera in Haiti, over half of which would be expected to occur in the Artibonite and Oueste provinces. If contaminated water consumption were reduced by 1% per week, as per current efforts, we expect 105,000 cases (95% CI: 88,000–116,000) and 1,500 (95% CI: 1,100–2,300) deaths to be averted. A plan to vaccinate 10% of the population beginning on March 1 would be predicted to avert 63,000 (95% CI: 48,000–78,000) cases and 900 (95% CI: 600–1,500) deaths over the same period. By contrast, the proposal to extend antibiotic use to all patients with severe dehydration and half of patients with moderate dehydration would be expected to avert 9,000 (95% CI: 8,000–10,000) cases and 1,300 (95% CI: 900–2,000) deaths. Interpretation A decline in cholera prevalence in early 2011 is part of the natural history of the epidemic, and should not be interpreted as reflective of the success of human interventions. Vibrio cholerae in Haiti is expected to produce at least 750,000 cholera cases by November 2011, substantially higher than official estimates currently used for resource allocation. In addition to clean water provision and vaccination, expanded access to antibiotics may avert thousands of deaths. PMID

Women’s and Healthcare Workers’ Beliefs and Experiences Surrounding Abortion: The Case of Haiti

PubMed Central

Albuja, Laura Dean; Cianelli, Rosina; Anglade, Debbie; Owusu, Brenda; Joseph, Laly; Sailsman, Sonique; Ferrer, Lilian

2017-01-01

Purpose Women in developing countries usually encounter serious inequities in terms of women’s health. To date, there is limited understanding of abortion from the perspective of Haitian women. As a limited-resource country, Haiti faces complex social issues and healthcare challenges. With abortion being illegal, many adult and teenage women seek clandestine abortions. The aim of this study was to explore and gain a greater understanding of women’s and healthcare workers’ beliefs and experiences about abortion in Haiti. Methods Descriptive qualitative design was used to elicit information for the study. Eight focus groups were conducted with Haitian women and healthcare workers in five communities in the south of Haiti: Les Cayes, Aquin, St. Louis du Sud, Cavaillon, Maniche, and Ile a Vache. Participants were purposively selected and consented to participate and to be tape recorded. Content analysis followed using the verbatim transcripts, with triangulation of four researchers; saturation was reached with this number of focus groups. Findings The transcripts revealed six main themes regarding beliefs and experiences about abortion in Haiti: cultural aspects, consumers, perils of care, and legal concerns. Both women and healthcare workers discussed the repercussions of illegal abortion and the role of the government and hospitals. Participants identified similar perils and complications of unsafe abortions, such as postpartum hemorrhage and infection. Conclusions Results showed an urgent need to create a public health response that addresses different dimensions of abortion by engaging women and healthcare providers in rapid and concrete actions that promote access and safe care of women. It is imperative to conduct more research related to abortion in order to examine other associated factors to better understand the links between abortion and sexual health disparities among Haitian women. These results highlight the need for a rapid response to the need of

Epidemiology of Traumatic Injuries in the Northeast Region of Haiti: A Cross-sectional Study.

PubMed

Aluisio, Adam R; De Wulf, Annelies; Louis, Ambert; Bloem, Christina

2015-12-01

More than 90% of traumatic morbidity and mortality occurs in low- and middle-income countries (LMIC). Haiti is the poorest country in the Western Hemisphere and lacks contemporary statistics on the epidemiology of traumatic injuries. This study aimed to characterize the burden of traumatic injuries among emergency department patients in the Northeast region of Haiti. Data were collected from the emergency departments of all public hospitals in the Northeast region of Haiti, which included the Fort Liberté, Ouanaminthe, and Trou du Nord sites. All patients presenting for emergent care of traumatic injuries were included. Data were obtained via review of emergency department registries and patient records from October 1, 2013 through November 30, 2013. Data on demographics, mechanisms of trauma, and anatomical regions of injury were gathered using a standardized tool and analyzed using descriptive statistics. Temporal analysis of injury frequency was explored using regression modeling. Data from 383 patient encounters were accrued. Ouanaminthe Hospital treated the majority of emergent injuries (59.3%), followed by Fort Liberté (30.3%) and Trou du Nord (10.4%). The median age in years was 23 with 23.1% of patients being less than 15 years of age. Road traffic accidents (RTAs) and interpersonal violence accounted for 65.8% and 30.1% of all traumatic mechanisms, respectively. Extremity trauma was the most frequently observed anatomical region of injury (38.9%), followed by head and neck (30.3%) and facial (19.1%) injuries. Trauma due to RTA resulted in a single injury (83.8%) to either an extremity or the head and neck regions most frequently. A minority of patients had medical record documentation (37.9%). Blood pressure, respiratory rate, and mental status were documented in 19.3%, 4.1%, and 0.0% of records, respectively. There were 6.3 injuries/day during the data collection period with no correlation between the frequency of emergent trauma cases and day of the

Situation Reports--Ceylon, Costa Rica, Ghana, Haiti, Morocco, Sudan, Tunisia, and U.S.A.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in eight countries are presented in these situation reports. Countries included are Ceylon, Costa Rica, Ghana, Haiti, Morocco, Sudan, Tunisia, and the United States of America. Information is provided under two topics, general background and family planning situation, where appropriate and if it is…

77 FR 76503 - Extension of the Re-registration Period for Haiti Temporary Protected Status

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-28

... Docket No. USCIS-2012-0009] RIN 1615-ZB14 Extension of the Re-registration Period for Haiti Temporary...: Notice; Extension of Re-registration Period. SUMMARY: On October 1, 2012, the Secretary of Homeland... 60- day re-registration period from October 1, 2012 through November 30, 2012. Due to the effects of...

Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care

PubMed Central

Jacobs, Lee D; Judd, Thomas M; Bhutta, Zulfiqar A

2016-01-01

The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries. To create a major change in Haiti’s health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic “community care grids” to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis. We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti’s health care system will be among the leaders in that region. PMID:26934625

First report of the natural occurrence of tomato chlorotic spot virus in peanuts in Haiti

USDA-ARS?s Scientific Manuscript database

Tomato chlorotic spot virus (TCSV) was identified in peanut in Haiti. This is the first report of TCSV naturally infecting peanut. Genetic diversity of TCSV was characterized. This report provides an overview of this emerging virus for growers, extension workers, crop consultants and research and...

Assessing the causes of under-five mortality in the Albert Schweitzer Hospital service area of rural Haiti.

PubMed

Perry, Henry B; Ross, Allen G; Fernand, Facile

2005-09-01

Limited information is available regarding the causes of under-five mortality in nearly all of the countries in which mortality is the highest. The purpose of this study was to use a standard computerized protocol for defining the leading causes of death among children in a high-mortality rural population of Haiti and to highlight the need for similar studies else-where in Haiti and throughout the high-mortality areas of Latin America and the Caribbean. In 2001 a standardized, closed-ended verbal autopsy questionnaire endorsed by the World Health Organization was administered to a representative, population-based sample of the mothers or other caregivers of 97 children who had died before reaching 5 years of age between 1995 and 1999 in the service area of the Albert Schweitzer Hospital, which is located in the rural Artibonite Valley of Haiti. With the data from the questionnaires we used a computerized algorithm to generate diagnoses of the cause of death; the algorithm made it possible to have more than one cause of death. Acute lower respiratory infection (ALRI) was the leading diagnosis, present in 45% of all under-five deaths, followed by enteric diseases, present in 21% of deaths. Neonatal tetanus, preterm birth, and other early neonatal causes unassociated with ALRI or diarrhea were present in 41% of the neonatal deaths. Among children 1-59 months of age, ALRI was present in 51% of the deaths, and enteric diseases in 30%. Deaths were concentrated during the first few months of life, with 35% occurring during the first month. Among the neonatal deaths, 27% occurred on the first day of life, and 80% occurred during the first 10 days of life. In the Albert Schweitzer Hospital program area--and presumably in other areas of Haiti as well--priority needs to be given to the prevention of and the early, effective treatment of ALRI, diarrhea, and early neonatal conditions. This study points to the need for more, similar standardized assessments to guide local

The Haiti Medical Education Project: development and analysis of a competency based continuing medical education course in Haiti through distance learning.

PubMed

Battat, Robert; Jhonson, Marc; Wiseblatt, Lorne; Renard, Cruff; Habib, Laura; Normil, Manouchka; Remillard, Brian; Brewer, Timothy F; Sacajiu, Galit

2016-10-19

Recent calls for reform in healthcare training emphasize using competency-based curricula and information technology-empowered learning. Continuing Medical Education programs are essential in maintaining physician accreditation. Haitian physicians have expressed a lack access to these activities. The Haiti Medical Education Project works in alliance with Haitian medical leadership, faculty and students to support the Country's medical education system. We present the creation, delivery and evaluation of a competency-based continuing medical education curriculum for physicians in rural Haiti. Real time lectures from local and international institutions were teleconferenced to physicians in remote Haitian sites using VidyoConferencing™ technology. With American Academy of Family Physicians (AAFP) and College of Family Physicians Canada (CFPC) guidelines as references, a competency-derived syllabus was created for a Haitian continuing medical education program. The resulting educational goals were reviewed by a committee of Haitian and North American physician/medical education practitioners to reflect local needs. All authors reviewed lectures and then conferred to establish agreement on competencies presented for each lecture. Sixty-seven lectures were delivered. Human immunodeficiency virus/Acquired Immunodeficiency Syndrome, ophthalmologic, infectious diseases, renal and endocrine competencies were well-represented, with more than 50 % of the joint AAFP and CFPC recommended competencies outlined. Areas under-represented included allergy and immunology, cardiology, surgery, pain management, gastroenterology, neurology, pulmonology, men's health and rheumatology; these topics accounted for less than 25 % of AAFP/CFPC recommended competencies. Areas not covered included geriatrics, nutrition, occupational health and women's health. Within practice-based lectures, only disaster medicine, health promotion and information management were included, but only partially

Situation Report--Bahamas, Bermuda, Bolivia, China, Costa Rica, Guadeloupe, Haiti, Hong Kong, Liberia, Mexico, Panama.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in 11 foreign countries are presented in these situation reports. Countries included are Bahamas, Bermuda, Boliva, China, Costa Rica, Guadeloupe, Haiti, Hong Kong, Liberia, Mexico, and Panama. Information is provided under two topics, general background and family planning situation, where…

The bat community of Haiti and evidence for its long-term persistence at high elevations

PubMed Central

Simmons, Nancy B.; Steadman, David W.

2017-01-01

Accurate accounts of both living and fossil mammal communities are critical for creating biodiversity inventories and understanding patterns of changing species diversity through time. We combined data from from14 new fossil localities with literature accounts and museum records to document the bat biodiversity of Haiti through time. We also report an assemblage of late-Holocene (1600–600 Cal BP) bat fossils from a montane cave (Trouing Jean Paul, ~1825m) in southern Haiti. The nearly 3000 chiropteran fossils from Trouing Jean Paul represent 15 species of bats including nine species endemic to the Caribbean islands. The fossil bat assemblage from Trouing Jean Paul is dominated by species still found on Hispaniola (15 of 15 species), much as with the fossil bird assemblage from the same locality (22 of 23 species). Thus, both groups of volant vertebrates demonstrate long-term resilience, at least at high elevations, to the past 16 centuries of human presence on the island. PMID:28574990

3D dynamic rupture simulation and local tomography studies following the 2010 Haiti earthquake

NASA Astrophysics Data System (ADS)

Douilly, Roby

The 2010 M7.0 Haiti earthquake was the first major earthquake in southern Haiti in 250 years. As this event could represent the beginning of a new period of active seismicity in the region, and in consideration of how vulnerable the population is to earthquake damage, it is important to understand the nature of this event and how it has influenced seismic hazards in the region. Most significantly, the 2010 earthquake occurred on the secondary Leogâne thrust fault (two fault segments), not the Enriquillo Fault, the major strike-slip fault in the region, despite it being only a few kilometers away. We first use a finite element model to simulate rupture along the Leogâne fault. We varied friction and background stress to investigate the conditions that best explain observed surface deformations and why the rupture did not to jump to the nearby Enriquillo fault. Our model successfully replicated rupture propagation along the two segments of the Leogâne fault, and indicated that a significant stress increase occurred on the top and to the west of the Enriquillo fault. We also investigated the potential ground shaking level in this region if a rupture similar to the Mw 7.0 2010 Haiti earthquake were to occur on the Enriquillo fault. We used a finite element method and assumptions on regional stress to simulate low frequency dynamic rupture propagation for the segment of the Enriquillo fault closer to the capital. The high-frequency ground motion components were calculated using the specific barrier model, and the hybrid synthetics were obtained by combining the low-frequencies ( 1Hz) from the stochastic simulation using matched filtering at a crossover frequency of 1 Hz. The average horizontal peak ground acceleration, computed at several sites of interest through Port-au-Prince (the capital), has a value of 0.35g. Finally, we investigated the 3D local tomography of this region. We considered 897 high-quality records from the earthquake catalog as recorded by

Cholera epidemic in Haiti, 2010: using a transmission model to explain spatial spread of disease and identify optimal control interventions.

PubMed

Tuite, Ashleigh R; Tien, Joseph; Eisenberg, Marisa; Earn, David J D; Ma, Junling; Fisman, David N

2011-05-03

Haiti is in the midst of a cholera epidemic. Surveillance data for formulating models of the epidemic are limited, but such models can aid understanding of epidemic processes and help define control strategies. To predict, by using a mathematical model, the sequence and timing of regional cholera epidemics in Haiti and explore the potential effects of disease-control strategies. Compartmental mathematical model allowing person-to-person and waterborne transmission of cholera. Within- and between-region epidemic spread was modeled, with the latter dependent on population sizes and distance between regional centroids (a "gravity" model). Haiti, 2010 to 2011. Haitian hospitalization data, 2009 census data, literature-derived parameter values, and model calibration. Dates of epidemic onset and hospitalizations. The plausible range for cholera's basic reproductive number (R(0), defined as the number of secondary cases per primary case in a susceptible population without intervention) was 2.06 to 2.78. The order and timing of regional cholera outbreaks predicted by the gravity model were closely correlated with empirical observations. Analysis of changes in disease dynamics over time suggests that public health interventions have substantially affected this epidemic. A limited vaccine supply provided late in the epidemic was projected to have a modest effect. Assumptions were simplified, which was necessary for modeling. Projections are based on the initial dynamics of the epidemic, which may change. Despite limited surveillance data from the cholera epidemic in Haiti, a model simulating between-region disease transmission according to population and distance closely reproduces reported disease patterns. This model is a tool that planners, policymakers, and medical personnel seeking to manage the epidemic could use immediately.

Timing and type of disaster severity data available on Internet following the 2010 Haiti Earthquake

PubMed Central

Wefer, Agnes; Von Schreeb, Johan

2012-01-01

Background To adequately plan relief, adequate information that describe and quantify the severity of a disaster, and estimate the number of affected population, is rapidly needed. However, needs assessments describing the severity of the disaster has been shown to be conducted too late in order to guide the first days relief interventions. The aim of this study was to assess availability of early disaster severity information on Internet during the first seven days following the 2010 Haiti earthquake and assess to which extent the information was consistent with later revelations. Methods We searched the well acknowledged web portal Relief Web for all Haiti postings during the first seven days (12 -18 January 2010) after the earthquake. A form was created to classify and quantify extracted severity variables found in the postings. The results were compiled, analysed and compared with CRED (Centre for Research on the Epidemiology of Disaster) official data made available later. Findings A total of 822 reports were posted where of 15 % provided a numerical estimate of the affected population, while 10% had an estimate on the number of dead. On day four 200 000 dead was reported, which is of the same magnitud compared to later official estimates (CRED data). Not a single report described the data collection method. Conclusions Within a few days of the 2010 Haiti earthquake it was possible to find surprisingly accurate information regarding severity of the earthquake but the available data must be questioned as no method was reported. More specialized and independent needs assessment agencies may improve availability of strategic information in the early onset of a disaster. PMID:23066517

Ground-water conditions in the Plaine de Moustiques, Haiti

USGS Publications Warehouse

Taylor, George C.; Lemoine, Rémy C.

1949-01-01

The Plaine des Moustiques lies on the north coast of Haiti about 12 kilometers west-southwest of Port-de-Paix. During January 1949 the writers made a brief geologic study to determine the availability of ground water in the plain for irrigation. At present irrigation is practiced by diversions from the Rivière des Moustiques. However, the dry-season flow of this stream is generally inadequate for irrigation or is sufficient to cover only a small part of the Irrigable area of the plain. According to Lieurance1 there is a total of about 1,120 hectares of irrigable land in the plain.

Evaluation of forest cover estimates for Haiti using supervised classification of Landsat data

NASA Astrophysics Data System (ADS)

Churches, Christopher E.; Wampler, Peter J.; Sun, Wanxiao; Smith, Andrew J.

2014-08-01

This study uses 2010-2011 Landsat Thematic Mapper (TM) imagery to estimate total forested area in Haiti. The thematic map was generated using radiometric normalization of digital numbers by a modified normalization method utilizing pseudo-invariant polygons (PIPs), followed by supervised classification of the mosaicked image using the Food and Agriculture Organization (FAO) of the United Nations Land Cover Classification System. Classification results were compared to other sources of land-cover data produced for similar years, with an emphasis on the statistics presented by the FAO. Three global land cover datasets (GLC2000, Globcover, 2009, and MODIS MCD12Q1), and a national-scale dataset (a land cover analysis by Haitian National Centre for Geospatial Information (CNIGS)) were reclassified and compared. According to our classification, approximately 32.3% of Haiti's total land area was tree covered in 2010-2011. This result was confirmed using an error-adjusted area estimator, which predicted a tree covered area of 32.4%. Standardization to the FAO's forest cover class definition reduces the amount of tree cover of our supervised classification to 29.4%. This result was greater than the reported FAO value of 4% and the value for the recoded GLC2000 dataset of 7.0%, but is comparable to values for three other recoded datasets: MCD12Q1 (21.1%), Globcover (2009) (26.9%), and CNIGS (19.5%). We propose that at coarse resolutions, the segmented and patchy nature of Haiti's forests resulted in a systematic underestimation of the extent of forest cover. It appears the best explanation for the significant difference between our results, FAO statistics, and compared datasets is the accuracy of the data sources and the resolution of the imagery used for land cover analyses. Analysis of recoded global datasets and results from this study suggest a strong linear relationship (R2 = 0.996 for tree cover) between spatial resolution and land cover estimates.

Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti.

PubMed

Domercant, Jean Wysler; Puttkammer, Nancy; Young, Paul; Yuhas, Krista; François, Kesner; Grand'Pierre, Reynold; Lowrance, David; Adler, Michelle

2017-01-01

Access to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+. To assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti. Longitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan-Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition. Among 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9-37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6-52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001). ART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help reduce ART attrition.

Community health workers and smartphones for the detection of surgical site infections in rural Haiti: a pilot study.

PubMed

Matousek, Alexi; Paik, Ken; Winkler, Eric; Denike, Jennifer; Addington, Stephen R; Exe, Chauvet; Louis, Rodolphe R E Jean; Riviello, Robert

2015-04-27

Absence of outcome data is a barrier to quality improvement in resource poor settings. To address this challenge, we set out to determine whether follow up for surgical site infections (SSIs) using community health workers (CHWs) and smartphones is feasible in rural Haiti. In this pilot study, all patients from a specific mountain region who received an operation between March 10, and July 1, 2014, at Hôpital Albert Schweitzer in rural Haiti were eligible for inclusion. Patients or guardians of minors were approached for consent. We designed a smartphone application to enable CHWs to screen for SSIs during home visits by administering a questionnaire, obtaining GPS data, and submitting a photograph of an incision. We selected and trained CHWs to use the smartphone application and compensated them based on performance. CHWs completed home visits for 30 days after an operation for all participants. Surgeons examined all participants within 24 h after the second CHW home visit. Primary outcomes included the number of participants completing 30-day follow-up and home visits made on time. Secondary outcomes included the quality of the photographs and the agreement between surgeons and CHWs on the diagnosis of SSI. The Partners Healthcare institutional review board and the Ethics Committee at Hôpital Albert Schweitzer approved the study protocol. Five CHWs completed 30-day follow up for 37 of 39 participants (94·9%) and completed 107 of 117 home visits on time (91·5%). High quality photographs were submitted for 101 of 117 visits (86·3%). Surgeons and CHWs agreed on the diagnosis of SSI in 28 of 33 cases (84·8%). Outpatient follow up for SSIs with CHWs and smartphones is feasible in rural Haiti. Further validation of the programme needs to be done before widespread adoption or advocating for task shifting post-operative follow up to CHWs. Partners Healthcare, Children's Hospital Boston, and Swiss Bündner Partnerschaft Hôpital Albert Schweitzer Haiti. Copyright �

Geological Deformations and Potential Hazards Triggered by the 01-12-2010 Haiti Earthquake: Insights from Google Earth Imagery

NASA Astrophysics Data System (ADS)

Doblas, M.; Benito, B.; Torres, Y.; Belizaire, D.; Dorfeuille, J.; Aretxabala, A.

2013-05-01

In this study we compare the different Google Earth imagery (GEI) available before and after the 01-12-2010 earthquake of Haiti and carry out a detailed analysis of the superficial seismic-related geological deformations in the following sites: 1) the capital Port-Au-Prince and other cities (Carrefour and Gresslier); 2) the mountainous area of the Massif de la Selle which is transected by the "Enriquillo-Plaintain-Garden" (EPG) interplate boundary-fault (that supposedly triggered the seism); 3) some of the most important river channels and their corresponding deltas (Momanche, Grise and Frorse). The initial results of our researches were published in March 2010 in a special web page created by the scientific community to try to mitigate the devastating effects of this catastrophe (http://supersites.earthobservations.org/haiti.php). Six types of superficial geological deformations triggered by the seismic event have been identified with the GEI: liquefaction structures, chaotic rupture zones, coastal and domal uplifts, river-delta turnovers, faults/ruptures and landslides. Potential geological hazards triggered by the Haiti earthquake include landslides, inundations, reactivation of active tectonic elements (e.g., fractures), river-delta turnovers, etc. We analyzed again the GEI after the rain period and, as expected, most of the geological deformations that we initially identified had been erased and/or modified by the water washout or buried by the sediments. In this sense the GEI constitutes an invaluable instrument in the analysis of seismic geological hazards: we still have the possibility to compare all the images before and after the seism that are recorded in its useful "time tool". These are in fact the only witnesses of most of the geological deformations triggered by the Haiti earthquake that remain stored in the virtual archives of the GEI. In fact a field trip to the area today would be useless as most of these structures have disappeared. We will show

The Health Impact of Rabies in Haiti and Recent Developments on the Path Toward Elimination, 2010–2015

PubMed Central

Wallace, Ryan; Etheart, Melissa; Ludder, Fleurinord; Augustin, Pierre; Fenelon, Natael; Franka, Richard; Crowdis, Kelly; Dely, Patrick; Adrien, Paul; Pierre-Louis, J.; Osinubi, Modupe; Orciari, Lillian; Vigilato, Marco; Blanton, Jesse; Patel, Roopal; Lowrance, David; Liverdieu, Andrecy; Coetzer, Andre; Boone, John; Lindenmayer, Joanne; Millien, M.

2017-01-01

Abstract. Haiti, a Caribbean country of 10.5 million people, is estimated to have the highest burden of canine-mediated human rabies deaths in the Western Hemisphere, and one of the highest rates of human rabies deaths in the world. Haiti is also the poorest country in the Western Hemisphere and has numerous economic and health priorities that compete for rabies-control resources. As a result, primary rabies-control actions, including canine vaccination programs, surveillance systems for human and animal rabies, and appropriate postbite treatment, have not been fully implemented at a national scale. After the 2010 earthquake that further hindered the development of public health program infrastructure and services, the U.S. Centers for Disease Control and Prevention worked with the Ministry of Public Health and Population and key health development partners (including the Pan-American Health Organization) to provide technical expertise and funding for general disease surveillance systems, laboratory capacity, and selected disease control programs; including rabies. In 2011, a cross-ministerial rabies consortium was convened with participation from multiple international rabies experts to develop a strategy for successful rabies control in Haiti. The consortium focused on seven pillars: 1) enhancement of laboratory diagnostic capacity, 2) development of comprehensive animal surveillance system, 3) development of comprehensive human rabies surveillance system, 4) educational outreach, 5) sustainable human rabies biologics supply, 6) achievement of sustained canine vaccination rates of ≥ 70%, and 7) finalization of a national rabies control strategy. From 2010 until 2015, Haiti has seen improvements in the program infrastructure for canine rabies control. The greatest improvements were seen in the area of animal rabies surveillance, in support of which an internationally recognized rabies laboratory was developed thereby leading to an 18-fold increase in the

Effective Use of Household Water Treatment and Safe Storage in Response to the 2010 Haiti Earthquake

PubMed Central

Lantagne, Daniele; Clasen, Thomas

2013-01-01

When water supplies are compromised during an emergency, responders often recommend household water treatment and safe storage (HWTS) methods, such as boiling or chlorination. We evaluated the near- and longer-term impact of chlorine and filter products distributed shortly after the 2010 earthquake in Haiti. HWTS products were deemed as effective to use if they actually improved unsafe household drinking water to internationally accepted microbiological water quality standards. The acute emergency survey (442 households) was conducted within 8 weeks of emergency onset; the recovery survey (218 households) was conducted 10 months after onset. Effective use varied by HWTS product (from 8% to 63% of recipients in the acute phase and from 0% to 46% of recipients in the recovery phase). Higher rates of effective use were associated with programs that were underway in Haiti before the emergency, had a plan at initial distribution for program continuation, and distributed products with community health worker support and a safe storage container. PMID:23836571

Forensic analysis of mtDNA haplotypes from two rural communities in Haiti reflects their population history.

PubMed

Wilson, Jamie L; Saint-Louis, Vertus; Auguste, Jensen O; Jackson, Bruce A

2012-11-01

Very little genetic data exist on Haitians, an estimated 1.2 million of whom, not including illegal immigrants, reside in the United States. The absence of genetic data on a population of this size reduces the discriminatory power of criminal and missing-person DNA databases in the United States and Caribbean. We present a forensic population study that provides the first genetic data set for Haiti. This study uses hypervariable segment one (HVS-1) mitochondrial DNA (mtDNA) nucleotide sequences from 291 subjects primarily from rural areas of northern and southern Haiti, where admixture would be minimal. Our results showed that the African maternal genetic component of Haitians had slightly higher West-Central African admixture than African-Americans and Dominicans, but considerably less than Afro-Brazilians. These results lay the foundation for further forensic genetics studies in the Haitian population and serve as a model for forensic mtDNA identification of individuals in other isolated or rural communities. © 2012 American Academy of Forensic Sciences.

Ruptures, rights, and repair: the political economy of trauma in Haiti.

PubMed

James, Erica Caple

2010-01-01

This article analyzes the unintended consequences of humanitarian and development interventions in Haiti implemented to facilitate its postconflict transition following the period of military rule between 1991 and 1994. International and national governmental and nongovernmental initiatives to provide redress and healing to victims of human rights abuses from this period inadvertently contributed to the growth of a political economy of trauma. I argue that state-sponsored and non-state interventions aimed at truth seeking, acknowledging past ruptures, and reparations have intersected with the politics of local communities in ways that contribute to the commoditization of suffering in the political economy of trauma. The experience of a woman whose bodily integrity and personal sovereignty were violated by members of Haiti's terror apparatus demonstrates the presence of a terror economy. My witnessing of her interactions with the international and national humanitarian and development aid organizations that assisted her in the aftermath of violation revealed the contours of the compassion economy. It is the compassion economy that is the particular focus of this article. I evaluate whether rendering visible or audible the individual and collective suffering of the past truly aid processes of social reconstruction, democratization, and peace building, especially in states plagued with ongoing social, political, and economic insecurity. I argue that the forms of citizenship that these interventions engender are rarely permanent, especially in fragile or failed states, and may exacerbate the societal cleavages that gave rise to conflict.

Therapeutic Efficacy of Chloroquine for the Treatment of Uncomplicated Plasmodium falciparum in Haiti after Many Decades of its Use

PubMed Central

Okech, Bernard A.; Existe, Alexandre; Romain, Jean R.; Memnon, Gladys; Victor, Yves Saint; de Rochars, Madsen Beau; Fukuda, Mark

2015-01-01

Chloroquine (CQ) has been used for malaria treatment in Haiti for several decades, but reports of CQ resistance are scarce. The efficacy of CQ in patients with uncomplicated Plasmodium falciparum undergoing treatment in Haiti was evaluated. Malaria patients were enrolled, treated with CQ, and monitored over a 42-day period. The treatment outcomes were evaluated on day 28 by microscopy. The P. falciparum slide-confirmed rate was 9.5% (121 of 1,277). Malaria infection was seasonal, with peak observations between October and January; 88% (107 of 121) of patients consented to participate. Sixty patients successfully completed the 42-day follow-up, whereas 47 patients withdrew consent or were lost to follow-up. The mean parasite density declined rapidly within the first few days after treatment. Seven patients did not clear their malaria infections and were clinically asymptomatic; therefore, they were considered late parasitological failures. About 90% (95% confidence interval = 84.20–97.90) of patients had no detectable parasitemia by day 28 and remained malaria-free to day 42. Testing for recrudescence, reinfection, and CQ serum levels was not done in the seven patients, and therefore, their CQ resistance status is unresolved. CQ resistance surveillance by patient follow-up, in vitro drug sensitivity studies, and molecular markers is urgently needed in Haiti. PMID:25601993

Reproductive and Birth Outcomes in Haiti Before and After the 2010 Earthquake.

PubMed

Harville, Emily W; Do, Mai

2016-02-01

We aimed to examine the relationship between exposure to the 2010 Haiti earthquake and pregnancy wantedness, interpregnancy interval, and birth weight. From the nationally representative Haiti 2012 Demographic and Health Survey, information on "size of child at birth" (too small or not) was available for 7280 singleton births in the previous 5 years, whereas information on birth weight was available for 1607 births. Pregnancy wantedness, short (<1 year) interpregnancy interval, and maternal-reported birth weight were compared before and after the earthquake and by level of damage. Multiple logistic regression and linear regression analyses were conducted. Post-earthquake births were less likely to be wanted and more likely to be born after a short interpregnancy interval. Earthquake exposure was associated with increased likelihood of a child being born too small: timing of birth (after earthquake vs. before earthquake, adjusted odds ratio [aOR]: 1.27, 95% confidence interval [CI]: 1.12-1.45), region (hardest-hit vs. rest of country; aOR: 1.43, 95% CI: 1.14- 1.80), and house damage (aOR: 1.27 95% CI: 1.02-1.58). Mean birth weight was 150 to 300 g lower in those exposed to the earthquake. Experience with the earthquake was associated with worse reproductive and birth outcomes, which underscores the need to provide reproductive health services as part of relief efforts.

The impact of economic sanctions on health and human rights in Haiti, 1991-1994.

PubMed Central

Gibbons, E; Garfield, R

1999-01-01

OBJECTIVES: This report examines the impact of an economic embargo from 1991 to 1994 on health, well-being, and human rights in Haiti. METHODS: Data from surveillance systems for nutrition, reportable diseases, and hospital diagnoses were combined with survey data and interviews with affected women, governmental representatives, diplomats, and staff of nongovernmental organizations. RESULTS: Changes included declining income, rising unemployment, poorer nutrition, declining infant mortality, rising mortality among 1- to 4-year-olds, decreased attention to children's well-being and education, and family breakdown. Survival strategies among poor Haitians included changed dietary habits, informal-sector economic activity, moving in with relatives, selling domestic goods, increased informal unions among couples, decreased school attendance, and indentured servitude among children. CONCLUSIONS: The implementation of economic sanctions in Haiti resulted in extensive violations of rights; the impact was greatest on the most disadvantaged Haitians. Many Haitian and international supporters of democracy were unaware of the extensive negative impact that sanctions could have. The impact continues now, 5 years after sanctions ended. Modified policies reduced some of the burden of sanctions, and international assistance prevented what otherwise might have become a humanitarian disaster during sanctions. PMID:10511830

Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti.

PubMed

Ayoya, Mohamed Ag; Golden, Kate; Ngnie-Teta, Ismael; Moreaux, Marjolein D; Mamadoultaibou, Aissa; Koo, Leslie; Boyd, Erin; Beauliere, Jean Max; Lesavre, Celine; Marhone, Joseline Pierre

2013-08-01

The 2010 earthquake in Haiti displaced about 1.5 million people, many of them into camps for internally displaced persons. It was expected that disruption of breastfeeding practices would lead to increased infant morbidity, malnutrition and mortality. Haiti's health ministry and the United Nations Children's Fund, in collaboration with local and international nongovernmental organizations, established baby tents in the areas affected by the earthquake. The tents provided a safe place for mothers to breastfeed and for non-breastfed infants to receive ready-to-use infant formula. Such a large and coordinated baby tent response in an emergency context had never been mounted before anywhere in the world. Baby tents were set up in five cities but mainly in Port-au-Prince, where the majority of Haiti's 1555 camps for displaced persons had been established. Between February 2010 and June 2012, 193 baby tents were set up; 180 499 mother-infant pairs and 52 503 pregnant women were registered in the baby tent programme. Of infants younger than 6 months, 70% were reported to be exclusively breastfed and 10% of the "mixed feeders" moved to exclusive breastfeeding while enrolled. In 2010, 13.5% of registered infants could not be breastfed. These infants received ready-to-use infant formula. Thanks to rapid programme scale-up, breastfeeding practices remained undisrupted. However, better evaluation methods and comprehensive guidance on the implementation and monitoring of baby tents are needed for future emergencies, along with a clear strategy for transitioning baby tent activities into facility and community programmes.

Experience of People With Disabilities in Haiti Before and After the 2010 Earthquake: WHODAS 2.0 Documentation.

PubMed

Parker, Kim; Adderson, James; Arseneau, Marc; O'Connell, Colleen

2015-09-01

To describe the functioning and participation of people with disabilities seen in Haiti Team Canada Healing Hands clinics before and after the 2010 earthquake. Cross-sectional survey. Rehabilitation clinics. A convenience sample of individuals attending Team Canada Healing Hands clinics (N=194): individuals who completed the survey before the 2010 earthquake (n=72) and individuals who completed the survey after the 2010 earthquake (n=122). Not applicable. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Overall WHODAS 2.0 scores before and after the 2010 earthquake were in the top 10th percentile of population normative data, where higher scores reflect greater disability. A median increase (6.6 points) in disability was reported after the earthquake (Mann-Whitney U, P=.055). There was a significant increase (Mann-Whitney U, P<.001) in WHODAS 2.0 scores related to mobility (18.8 points), life activities (30 points), and participation (16.7 points) domains after the earthquake. Persons in Haiti with a disability attending Team Canada Healing Hands clinics reported a low level of functioning. The increase in WHODAS 2.0 scores related to mobility, life activities, and participation domains suggests that the 2010 earthquake had a negative impact on functioning of this population and provides additional information on the responsiveness of the WHODAS 2.0 in limited resource settings. Future work can include using WHODAS 2.0 to monitor the impact of rehabilitation service and advocacy initiatives in Haiti and similar locations. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Feasibility of the hydrogen sulfide test for the assessment of drinking water quality in post-earthquake Haiti.

PubMed

Weppelmann, Thomas A; Alam, Meer T; Widmer, Jocelyn; Morrissey, David; Rashid, Mohammed H; De Rochars, Valery M Beau; Morris, J Glenn; Ali, Afsar; Johnson, Judith A

2014-12-01

In 2010, a magnitude 7.0 earthquake struck Haiti, severely damaging the drinking and wastewater infrastructure and leaving millions homeless. Compounding this problem, the introduction of Vibrio cholerae resulted in a massive cholera outbreak that infected over 700,000 people and threatened the safety of Haiti's drinking water. To mitigate this public health crisis, non-government organizations installed thousands of wells to provide communities with safe drinking water. However, despite increased access, Haiti currently lacks the monitoring capacity to assure the microbial safety of any of its water resources. For these reasons, this study was designed to assess the feasibility of using a simple, low-cost method to detect indicators of fecal contamination of drinking water that could be implemented at the community level. Water samples from 358 sources of drinking water in the Léogâne flood basin were screened with a commercially available hydrogen sulfide test and a standard membrane method for the enumeration of thermotolerant coliforms. When compared with the gold standard method, the hydrogen sulfide test had a sensitivity of 65 % and a specificity of 93 %. While the sensitivity of the assay increased at higher fecal coliform concentrations, it never exceeded 88 %, even with fecal coliform concentrations greater than 100 colony-forming units per 100 ml. While its simplicity makes the hydrogen sulfide test attractive for assessing water quality in low-resource settings, the low sensitivity raises concerns about its use as the sole indicator of the presence or absence of fecal coliforms in individual or community water sources.

Strategies to Prevent Cholera Introduction during International Personnel Deployments: A Computational Modeling Analysis Based on the 2010 Haiti Outbreak

PubMed Central

Lewnard, Joseph A.; Antillón, Marina; Gonsalves, Gregg; Miller, Alice M.; Ko, Albert I.; Pitzer, Virginia E.

2016-01-01

Background Introduction of Vibrio cholerae to Haiti during the deployment of United Nations (UN) peacekeepers in 2010 resulted in one of the largest cholera epidemics of the modern era. Following the outbreak, a UN-commissioned independent panel recommended three pre-deployment intervention strategies to minimize the risk of cholera introduction in future peacekeeping operations: screening for V. cholerae carriage, administering prophylactic antimicrobial chemotherapies, or immunizing with oral cholera vaccines. However, uncertainty regarding the effectiveness of these approaches has forestalled their implementation by the UN. We assessed how the interventions would have impacted the likelihood of the Haiti cholera epidemic. Methods and Findings We developed a stochastic model for cholera importation and transmission, fitted to reported cases during the first weeks of the 2010 outbreak in Haiti. Using this model, we estimated that diagnostic screening reduces the probability of cases occurring by 82% (95% credible interval: 75%, 85%); however, false-positive test outcomes may hamper this approach. Antimicrobial chemoprophylaxis at time of departure and oral cholera vaccination reduce the probability of cases by 50% (41%, 57%) and by up to 61% (58%, 63%), respectively. Chemoprophylaxis beginning 1 wk before departure confers a 91% (78%, 96%) reduction independently, and up to a 98% reduction (94%, 99%) if coupled with vaccination. These results are not sensitive to assumptions about the background cholera incidence rate in the endemic troop-sending country. Further research is needed to (1) validate the sensitivity and specificity of rapid test approaches for detecting asymptomatic carriage, (2) compare prophylactic efficacy across antimicrobial regimens, and (3) quantify the impact of oral cholera vaccine on transmission from asymptomatic carriers. Conclusions Screening, chemoprophylaxis, and vaccination are all effective strategies to prevent cholera introduction

75 FR 78215 - Limitation of Duty-free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

...: Notification of Annual Quantitative Limit on Certain Apparel under HOPE. DATES: Effective Date: December 20...-added program is subject to a quantitative limitation. HOPE provides that the quantitative limitation... quantitative limitation for qualifying apparel imported from Haiti under the value-added program will be an...

76 FR 78241 - Limitation of Duty-Free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-16

...: Notification of Annual Quantitative Limit on Certain Apparel under HOPE. DATES: Effective Date: December 20...-added program is subject to a quantitative limitation. HOPE provides that the quantitative limitation... quantitative limitation for qualifying apparel imported from Haiti under the value-added program will be an...

77 FR 75148 - Limitation of Duty-Free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... quantitative limit on certain apparel under HOPE. DATES: Effective Date: December 20, 2012. FOR FURTHER...-added program is subject to a quantitative limitation. HOPE provides that the quantitative limitation... beginning on December 20, 2012, the quantitative limitation for qualifying apparel imported from Haiti under...

78 FR 76817 - Limitation of Duty-Free Imports of Apparel Articles Assembled in Haiti Under the Haitian...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-19

...: Notification of Annual Quantitative Limit on Certain Apparel under HOPE. DATES: Effective Date: December 20...-added program is subject to a quantitative limitation. HOPE provides that the quantitative limitation... quantitative limitation for qualifying apparel imported from Haiti under the value-added program will be an...

Haiti: Feasibility of Waste-to-Energy Options at the Trutier Waste Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conrad, M. D.; Hunsberger, R.; Ness, J. E.

2014-08-01

This report provides further analysis of the feasibility of a waste-to-energy (WTE) facility in the area near Port-au-Prince, Haiti. NREL's previous analysis and reports identified anaerobic digestion (AD) as the optimal WTE technology at the facility. Building on the prior analyses, this report evaluates the conceptual financial and technical viability of implementing a combined waste management and electrical power production strategy by constructing a WTE facility at the existing Trutier waste site north of Port-au-Prince.

Performance of Charcoal Cookstoves for Haiti, Part 2: Results from the Controlled Cooking Test

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lask, Kathleen; Jones, Jennifer; Booker, Kayje

2011-11-30

Five charcoal cookstoves were tested using a Controlled Cooking Test (CCT) developed from cooking practices in Haiti. Cookstoves were tested for total burn time, specific fuel consumption, and emissions of carbon monoxide (CO), carbon dioxide (CO 2), and the ratio of carbon monoxide to carbon dioxide (CO/CO 2). These results are presented in this report along with LBNL testers’ observations regarding the usability of the stoves.

Reaching the global community during disasters: findings from a content analysis of the organizational use of Twitter after the 2010 Haiti earthquake.

PubMed

Gurman, Tilly A; Ellenberger, Nicole

2015-01-01

Social networking sites provide virtual environments in which individuals and organizations exchange real-time information on a multitude of topics, including health promotion and disease prevention. The January 2010 earthquake in Haiti has been posited as a turning point in the way in which organizations use social media, such as Twitter, for crisis communication. The purpose of this content analysis was to explore whether organizations' use of Twitter changed after the 2010 Haiti earthquake. A team of 13 coders analyzed all English-language tweets (N = 2,616) during the 3 months before and post earthquake from 6 leading organizations in the Haiti disaster relief efforts. Study findings indicate that the ways in which organizations used Twitter changed over time. Chi-square analyses demonstrated that organizations decreased in their use of certain strategies to disseminate information through Twitter, such as the use of links. Organizations did not change in their use of techniques to involve users (e.g., retweet, call to action), with the exception of using tweets as a fundraising mechanism. Study findings highlight missed opportunities among organizations to maximize Twitter in order to encourage more interactive and immediate communication with the global community.

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success.

PubMed

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-10-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti's neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a "directly observed treatment" strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained- 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH-and the significant reduction in burden of infection- 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti's very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of "best practices" for NTD control but

Soccer and sexual health education: a promising approach for reducing adolescent births in Haiti.

PubMed

Kaplan, Kathryn C; Lewis, Judy; Gebrian, Bette; Theall, Katherine

2015-05-01

To explore the effect of an innovative, integrative program in female sexual reproductive health (SRH) and soccer (or fútbol, in Haitian Creole) in rural Haiti by measuring the rate of births among program participants 15-19 years old and their nonparticipant peers. A retrospective cohort study using 2006-2009 data from the computerized data-tracking system of the Haitian Health Foundation (HHF), a U.S.-based nongovernmental organization serving urban and rural populations in Haiti, was used to assess births among girls 15-19 years old who participated in HHF's GenNext program, a combination education-soccer program for youth, based on SRH classes HHF nurses and community workers had been conducting in Haiti for mothers, fathers, and youth; girl-centered health screenings; and an all-female summer soccer league, during 2006-2009 (n = 4 251). Bivariate and multiple logistic regression analyses were carried out to assess differences in the rate of births among program participants according to their level of participation (SRH component only ("EDU") versus both the SRH and soccer components ("SO") compared to their village peers who did not participate. Hazard ratios (HRs) of birth rates were estimated using Cox regression analysis of childbearing data for the three different groups. In the multiple logistic regression analysis, only the girls in the "EDU" group had significantly fewer births than the nonparticipants after adjusting for confounders (odds ratio = 0.535; 95% confidence interval (CI) = 0.304, 0.940). The Cox regression analysis demonstrated that those in the EDU group (HR = 0.893; 95% CI = 0.802, 0.994) and to a greater degree those in the SO group (HR = 0.631; 95% CI = 0.558, 0.714) were significantly protected against childbearing between the ages of 15 and 19 years. HHF's GenNext program demonstrates the effectiveness of utilizing nurse educators, community mobilization, and youth participation in sports, education, and structured youth groups to

The Role of Science and Engineering in Rebuilding a More Resilient Haiti (Invited)

NASA Astrophysics Data System (ADS)

Applegate, D.

2010-12-01

Rebuilding a more disaster-resilient Haiti is the defining challenge in the wake of the devastating magnitude-7 earthquake that struck in January. The contrasting experience of Chile, which weathered a magnitude-8.8 earthquake in April with casualties in the hundreds, teaches us that building resilience is an achievable and desirable goal given suitable investments and governance. Scientists and engineers have much to contribute, but doing so requires effective mechanisms to enable them to inform the rebuilding process. The international donor community has been a key point of engagement since their funds provide the opportunity to build new schools, hospitals, critical infrastructure and housing that will not fail in the next disaster. In advance of a gathering of international donors at the end of March, the U.S. National Science and Technology Council’s interagency Subcommittee on Disaster Reduction convened a workshop that brought together over 100 scientists, engineers, planners, and policymakers, including a delegation of Haitian government officials and academics. Hosted by the University of Miami and organized by the Incorporated Research Institutions for Seismology, the workshop was co-sponsored by the U.S. Department of State, U.S. Agency for International Development (USAID), and United Nations International Strategy for Disaster Reduction with support from NASA, the National Science Foundation, and the U.S. Geological Survey (USGS). Key findings from the workshop covered the need to adopt and enforce international building codes, to use hazard assessments for earthquakes, inland flooding, and landslides in the planning process, and the central importance of long-term capacity building. As an example of one science agency’s contributions, the USGS informed the initial response by rapidly characterizing the earthquake and delivering estimates of population exposure to strong shaking that were used by humanitarian organizations, aid agencies, and the

Diarrheal illness among US residents providing medical services in Haiti during the cholera epidemic, 2010 to 2011.

PubMed

Schilling, Katharine A; Cartwright, Emily J; Stamper, John; Locke, Michael; Esposito, Douglas H; Balaban, Victor; Mintz, Eric

2014-01-01

Although nosocomial transmission of cholera is rare, two US healthcare workers (HCW) became ill with cholera after providing medical services during the Haiti cholera epidemic. To assess the incidence of diarrheal illness and explore preventive health behaviors practiced by US residents who provided medical services in Haiti, we conducted a cross-sectional, anonymous, web-based survey. We e-mailed 896 participants from 50 US-based, health-focused non-governmental organizations (NGOs), of whom 381 (43%) completed the survey. Fifty-six percent of respondents (n = 215) reported providing some care for patients with cholera. Diarrhea was reported by 31 (8%) respondents. One person was diagnosed with cholera by serologic testing. NGOs responding to international emergencies should ensure ample access to basic hygiene supplies and should promote their use to reduce the incidence of diarrheal illness among HCW working overseas. Published 2013.This article is a U.S.Government work and is in the public domain in the USA.

Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti

PubMed Central

Domercant, Jean Wysler; Puttkammer, Nancy; Young, Paul; Yuhas, Krista; François, Kesner; Grand’Pierre, Reynold; Lowrance, David; Adler, Michelle

2017-01-01

ABSTRACT Background: Access to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+. Objective: To assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti. Methods: Longitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan–Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition. Results: Among 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9–37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6–52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001). Conclusions: ART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help

Does quality influence utilization of primary health care? Evidence from Haiti.

PubMed

Gage, Anna D; Leslie, Hannah H; Bitton, Asaf; Jerome, J Gregory; Joseph, Jean Paul; Thermidor, Roody; Kruk, Margaret E

2018-06-20

Expanding coverage of primary healthcare services such as antenatal care and vaccinations is a global health priority; however, many Haitians do not utilize these services. One reason may be that the population avoids low quality health facilities. We examined how facility infrastructure and the quality of primary health care service delivery were associated with community utilization of primary health care services in Haiti. We constructed two composite measures of quality for all Haitian facilities using the 2013 Service Provision Assessment survey. We geographically linked population clusters from the Demographic and Health Surveys to nearby facilities offering primary health care services. We assessed the cross-sectional association between quality and utilization of four primary care services: antenatal care, postnatal care, vaccinations and sick child care, as well as one more complex service: facility delivery. Facilities performed poorly on both measures of quality, scoring 0.55 and 0.58 out of 1 on infrastructure and service delivery quality respectively. In rural areas, utilization of several primary cares services (antenatal care, postnatal care, and vaccination) was associated with both infrastructure and quality of service delivery, with stronger associations for service delivery. Facility delivery was associated with infrastructure quality, and there was no association for sick child care. In urban areas, care utilization was not associated with either quality measure. Poor quality of care may deter utilization of beneficial primary health care services in rural areas of Haiti. Improving health service quality may offer an opportunity not only to improve health outcomes for patients, but also to expand coverage of key primary health care services.

Rapid-Testing Technology and Systems Improvement for the Elimination of Congenital Syphilis in Haiti: Overcoming the "Technology to Systems Gap".

PubMed

Severe, Linda; Benoit, Daphne; Zhou, Xi K; Pape, Jean W; Peeling, Rosanna W; Fitzgerald, Daniel W; Mate, Kedar S

2013-01-01

Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child syphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than 3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time series, multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy. The two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on quality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (P < 0.001) and further increased to 96.8% (P < 0.001) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment lagged behind and only increased from 70.3% to 74.7% after the introduction of rapid tests (P = 0.27), but it improved significantly from 70.2% to 84.3% (P < 0.001) after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic testing and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare interventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of systems-based quality improvement approaches.

Establishment of a Canine Rabies Burden in Haiti through the Implementation of a Novel Surveillance Program

PubMed Central

Wallace, Ryan M; Reses, Hannah; Franka, Richard; Dilius, Pierre; Fenelon, Natael; Orciari, Lillian; Etheart, Melissa; Destine, Apollon; Crowdis, Kelly; Blanton, Jesse D; Francisco, Calvin; Ludder, Fleurinord; Del Rio Vilas, Victor; Haim, Joseph; Millien, Max

2015-01-01

The Republic of Haiti is one of only several countries in the Western Hemisphere in which canine rabies is still endemic. Estimation methods have predicted that 130 human deaths occur per year, yet existing surveillance mechanisms have detected few of these rabies cases. Likewise, canine rabies surveillance capacity has had only limited capacity, detecting only two rabid dogs per year, on average. In 2013, Haiti initiated a community-based animal rabies surveillance program comprised of two components: active community bite investigation and passive animal rabies investigation. From January 2013 –December 2014, 778 rabies suspect animals were reported for investigation. Rabies was laboratory-confirmed in 70 animals (9%) and an additional 36 cases were identified based on clinical diagnosis (5%), representing an 18-fold increase in reporting of rabid animals compared to the three years before the program was implemented. Dogs were the most frequent rabid animal (90%). Testing and observation ruled out rabies in 61% of animals investigated. A total of 639 bite victims were reported to the program and an additional 364 bite victims who had not sought medical care were identified during the course of investigations. Only 31% of people with likely rabies exposures had initiated rabies post-exposure prophylaxis prior to the investigation. Rabies is a neglected disease in-part due to a lack of surveillance and understanding about the burden. The surveillance methods employed by this program established a much higher burden of canine rabies in Haiti than previously recognized. The active, community-based bite investigations identified numerous additional rabies exposures and bite victims were referred for appropriate medical care, averting potential human rabies deaths. The use of community-based rabies surveillance programs such as HARSP should be considered in canine rabies endemic countries. PMID:26600437

Haiti's progress in achieving its 10-year plan to eliminate cholera: hidden sickness cannot be cured.

PubMed

Koski-Karell, Victoria; Farmer, Paul E; Isaac, Benito; Campa, Elizabeth M; Viaud, Loune; Namphy, Paul C; Ternier, Ralph; Ivers, Louise C

2016-01-01

Since the beginning of the cholera epidemic in Haiti 5 years ago, the prevalence of this deadly water-borne disease has fallen far below the initial rates registered during its explosive outset. However, cholera continues to cause extensive suffering and needless deaths across the country, particularly among the poor. The urgent need to eliminate transmission of cholera persists: compared to the same period in 2014, the first 4 months of 2015 saw three times the number of cholera cases. Drawing upon epidemiology, clinical work (and clinical knowledge), policy, ecology, and political economy, and informed by ethnographic data collected in a rural area of Haiti called Bocozel, this paper evaluates the progress of the nation's 10-year Plan for the Elimination of Cholera. Bocozel is a rice-producing region where most people live in extreme poverty. The irrigation network is decrepit, the land is prone to environmental shocks, fertilizer is not affordable, and the government's capacity to assist farmers is undermined by resource constraints. When peasants do have rice to sell, the price of domestically grown rice is twice that of US-imported rice. Canal water is not only used to irrigate thousands of acres of rice paddies and sustain livestock, but also to bathe, wash, and play, while water from wells, hand pumps, and the river is used for drinking, cooking, and bathing. Only one out of the three government-sponsored water treatment stations in the research area is still functional and utilized by those who can afford it. Latrines are scarce and often shared by up to 30 people; open defecation remains common. Structural vulnerabilities cut across all sectors - not just water, sanitation, health care, and education, but agriculture, environment, (global and local) commerce, transportation, and governance as well. These are among the hidden sicknesses that impede Haiti and its partners' capacity to eliminate cholera.

Macrocognition in Teams and Analysis of Information Flow During the Haiti Disaster Relief

DTIC Science & Technology

2011-06-01

supplies, clean water and electricity. TIE TIE TIE Local soccer field is now a safe landing ground for helicopters. TIE TIE TIE Five flights have...TIE TIE OR’s adequate medical supplies, clean water and electricity (generator) TIE TIE TIE Local soccer field is landing pad. TIE TIE TIE 5... soccer /helo pad, TIE TIE TIE Have own ambulances for transport. TIE TIE TIE 62 Contact: "NAME" (Ground Coordinator) Haiti cell "PHONE", "E

'It is me who eats, to nourish him': a mixed-method study of breastfeeding in post-earthquake Haiti.

PubMed

Dörnemann, Jenny; Kelly, Ann H

2013-01-01

In Haiti, initiation of breastfeeding is high, but early mixed feeding is the norm. In a situation of crisis, mothers' worries about insufficiency of breast milk, disruption of social networks and free unmonitored distribution of breast milk substitutes impact feeding practices. This study was conducted to explore the attitudes, practices and understandings of breastfeeding in the post-earthquake situation in Haiti. A mixed-method study was conducted in Léogâne, Haiti, a town close to the epicentre of the 2010 earthquake. In a household survey, 1131 mothers of children under 24 months were interviewed about feeding practices. In the quantitative component, we conducted 25 in-depth interviews and seven focus group discussions with mothers, grandmothers, traditional birth attendants, fathers and health care professionals. Mothers described breastfeeding as a challenging responsibility to ensure the infants' health. They understood breast milk as a dynamic substance, the quality of which would deteriorate if the mother's diet was poor or if the mother was afflicted with a psychosocial condition called move san or colere, 'bad blood'. To protect the child in these situations, early supplementary feeding is introduced. Only 20% of informants exclusively breastfed infants under 6 months. Because of a lack of confidence in the quality of breast milk, Haitian mothers tend to wean children earlier. The abiding concerns of Haitian mothers over the quality of their breast milk suggest a number of ways - such as dietary advice - that post-earthquake aid agencies could enhance breastfeeding support. © 2012 Blackwell Publishing Ltd.

Control of Dog Mediated Human Rabies in Haiti: No Time to Spare.

PubMed

Millien, Max F; Pierre-Louis, Jocelyne B; Wallace, Ryan; Caldas, Eduardo; Rwangabgoba, Jean M; Poncelet, Jean L; Cosivi, Ottorino; Del Rio Vilas, Victor J

2015-01-01

The American region has pledged to eliminate dog-mediated human rabies by 2015. As part of these efforts, we describe the findings of a desk and field mission review of Haiti's rabies situation by the end of 2013. While government officials recognize the importance of dog-mediated rabies control, and the national rabies plan adequately contemplates the basic capacities to that effect, regular and sufficient implementation, for example, of dog vaccination, is hampered by limited funding. Compounding insufficient funding and human resources, official surveillance figures do not accurately reflect the risk to the population, as evidenced by the large number of rabid dogs detected by focalized and enhanced surveillance activities conducted by the Ministry of Agriculture, Natural Resources and Rural Development (MARNDR) and the Health and Population Ministry (MSPP) with the technical assistance of the United States Centers for Disease Control and Prevention. Although international support is common, either in the form of on-the-ground technical support or donations of immunobiologicals, it is not comprehensive. In addition, there is limited coordination with MARNDR/MSPP and with other actors at the strategic or operational level due to human resources limitations. Given these findings, the 2015 elimination goal in the region is compromised by the situation in Haiti where control of the disease is not yet in sight despite the best efforts of the resolute national officials. More importantly, dog-mediated rabies is still a threat to the Haitian population.

Seismic hazard of the Enriquillog-Plantain Garden fault in Haiti inferred from palaeoseismology

USGS Publications Warehouse

Prentice, C.S.; Mann, P.; Crone, A.J.; Gold, R.D.; Hudnut, K.W.; Briggs, R.W.; Koehler, R.D.; Jean, P.

2010-01-01

The Enriquillog-Plantain Garden fault zone is recognized as one of the primary plate-bounding fault systems in Haiti. The strike-slip fault runs adjacent to the city of Port-au-Prince and was initially thought to be the source of the 12 January 2010, M w 7.0 earthquake. Haiti experienced significant earthquakes in 1751 and 1770 (refsA, 3, 4, 5), but the role of the Enriquillog-Plantain Garden fault zone in these earthquakes is poorly known. We use satellite imagery, aerial photography, light detection and ranging (LIDAR) and field investigations to document Quaternary activity on the Enriquillog-Plantain Garden fault. We report late Quaternary, left-lateral offsets of up to 160m, and a set of small offsets ranging from 1.3 to 3.3m that we associate with one of the eighteenth century earthquakes. The size of the small offsets implies that the historical earthquake was larger than M w 7.0, but probably smaller than M w 7.6. We found no significant surface rupture associated with the 2010 earthquake. The lack of surface rupture, coupled with other seismologic, geologic and geodetic observations, suggests that little, if any, accumulated strain was released on the Enriquillog-Plantain Garden fault in the 2010 earthquake. These results confirm that the Enriquillog-Plantain Garden fault remains a significant seismic hazard. ?? 2010 Macmillan Publishers Limited. All rights reserved.

Treatment of tuberculosis in a rural area of Haiti: directly observed and non-observed regimens. The experience of H pital Albert Schweitzer.

PubMed

Ollé-Goig, J E; Alvarez, J

2001-02-01

Artibonite Valley, a rural area in Haiti. To evaluate a tuberculosis control program in rural Haiti and to compare two strategies for treatment implemented in two areas that were not chosen at random: treatment delivered at the patients' homes observed by former tuberculosis patients (DOT), and non observed treatment (non-DOT). Retrospective analysis of the clinical records of adult patients diagnosed with tuberculosis at H pital Albert Schweitzer in Deschapelles, Haiti, during 1994-1995. There were 143 patients in the non-DOT group and 138 patients in the DOT group. The results of treatment were significantly different: in the non-DOT group 29% defaulted, 12% died and 58% had a successful outcome; in the DOT group 7% defaulted (P < 0.01), 4% died (P = 0.01) and 87% had a successful outcome (P < 0.01). These differences are also significant when considering only human immunodeficiency virus (HIV) infected patients (defaulted P < 0.01; died P = 0.09; successful outcome P < 0.01). Delivering treatment in patients' homes with direct observation by former tuberculosis patients can achieve good results, even in an area of extreme poverty and high rates of HIV infection. In this population the number of patients who are able to complete their treatment without observed administration is far from optimal.

Orthopaedic trauma care in Haiti: a cost-effectiveness analysis of an innovative surgical residency program.

PubMed

Carlson, Lucas C; Slobogean, Gerard P; Pollak, Andrew N

2012-01-01

In an effort to sustainably strengthen orthopaedic trauma care in Haiti, a 2-year Orthopaedic Trauma Care Specialist (OTCS) program for Haitian physicians has been developed. The program will provide focused training in orthopaedic trauma surgery and fracture care utilizing a train-the-trainer approach. The purpose of this analysis was to calculate the cost-effectiveness of the program relative to its potential to decrease disability in the Haitian population. Using established methodology originally outlined in the World Health Organization's Global Burden of Disease project, a cost-effectiveness analysis was performed for the OTCS program in Haiti. Costs and disability-adjusted life-years (DALYs) averted were estimated per fellow trained in the OTCS program by using a 20-year career time horizon. Probabilistic sensitivity analysis was used to simultaneously test the joint uncertainty of the cost and averted DALY estimates. A willingness-to-pay threshold of $1200 per DALY averted, equal to the gross domestic product per capita in Haiti, was selected on the basis of World Health Organization's definition of highly cost-effective health interventions. The OTCS program results in an incremental cost of $1,542,544 ± $109,134 and 12,213 ± 2,983 DALYs averted per fellow trained. The cost-effectiveness ratio of $133.97 ± $34.71 per DALY averted is well below the threshold of $1200 per DALY averted. Furthermore, sensitivity analysis suggests that implementing the OTCS program is the economically preferred strategy with more than 95% probability at a willingness-to-pay threshold of $200 per DALY averted and across the entire range of potential variable inputs. The current economic analysis suggests the OTCS program to be a highly cost-effective intervention. Probabilistic sensitivity analysis demonstrates that the conclusions remain stable even when considering the joint uncertainty of the cost and DALY estimates. Copyright © 2012 International Society for

A ground-water reconnaissance in the Pine Forest region, Haiti

USGS Publications Warehouse

Taylor, George C.; Lemoine, Rémy C.

1949-01-01

The Pine Forest region is located in southeastern Haiti. The SHADA Forest Division headquarters near the eastern end of the region is about 98 kilometers by road from Port-au-Prince. In early February 1949 the writers made a brief geologic study of the region to determine the feasibility of drilling wells to obtain water for domestic, stock and small-scale industrial use. Existing water supplies are very scanty and undependable. There are no wells in the region, and springs are notably scarce and widely separated. Water supplies are now obtained principally from rain-water catchments or from roof-tops. These supplies frequently fail during prolonged dry periods and water must be hauled from great distances.

The Challenges of Inclusive Education in Haiti: Exploring the Perspectives and Experiences of Teachers and School Leaders

ERIC Educational Resources Information Center

Fevrier, Marie M.

2013-01-01

Haiti's educational system is integrated by default, yet its system has no provisions for students with special education needs. This has contributed to the many barriers to inclusive education in its educational system. One such barrier is the lack of attention to special education in the tertiary education of teachers. Teachers' inability to…

User perceptions of and willingness to pay for household container-based sanitation services: experience from Cap Haitien, Haiti

PubMed Central

Russel, Kory; Tilmans, Sebastien; Kramer, Sasha; Sklar, Rachel; Tillias, Daniel; Davis, Jennifer

2015-01-01

Household-level container-based sanitation (CBS) services may help address the persistent challenge of providing effective, affordable sanitation services for which low-income urban households are willing to pay. Little is known, however, about user perceptions of and demand for household CBS services. This study presents the results of a pilot CBS service programme in Cap Haitien, Haiti. One hundred and eighteen households were randomly selected to receive toilets and a twice-weekly collection service. After three months, changes in these households’ satisfaction with their sanitation situation, along with feelings of pride, modernity and personal safety, were compared to 248 households in two comparison cohorts. Following the service pilot, 71 per cent of participating households opted to continue with the container-based sanitation service as paying subscribers. The results from this study suggest that, in the context of urban Haiti, household CBS systems have the potential to satisfy many residents’ desire for safe, convenient and modern sanitation services. PMID:26640322

Rapid-Testing Technology and Systems Improvement for the Elimination of Congenital Syphilis in Haiti: Overcoming the “Technology to Systems Gap”

PubMed Central

Benoit, Daphne; Zhou, Xi K.; Pape, Jean W.; Peeling, Rosanna W.; Fitzgerald, Daniel W.; Mate, Kedar S.

2013-01-01

Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child syphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than 3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time series, multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy. The two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on quality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (P < 0.001) and further increased to 96.8% (P < 0.001) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment lagged behind and only increased from 70.3% to 74.7% after the introduction of rapid tests (P = 0.27), but it improved significantly from 70.2% to 84.3% (P < 0.001) after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic testing and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare interventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of systems-based quality improvement approaches. PMID:26316955

Mansonella ozzardi and its vectors in the New World: an update with emphasis on the current situation in Haiti.

PubMed

Raccurt, C P

2017-10-25

Mansonella ozzardi (Nematoda: Onchocercidae) is a little studied filarial nematode. This human parasite, transmitted by two families of dipteran vectors, biting midges (most of them members of the genus Culicoides) and blackflies (genus Simulium), is endemic to the Neotropical regions of the New World. With a patchy geographical distribution from southern Mexico to north-western Argentina, human infection with M. ozzardi is highly prevalent in some of the Caribbean islands, along riverine communities in the Amazon Basin, and on both sides of the border between Bolivia and Argentina. Studies conducted in Haiti between 1974 and 1984 allowed the first complete description of the adult worm and permitted clarification of the taxonomic position of this filarial species. This paper reports the known geographical distribution of M. ozzardi in Neotropical regions of the Americas, and focuses on the current situation in Haiti where this filariasis remains a completely neglected public health problem.

Map of landslides triggered by the January 12, 2010, Haiti earthquake

USGS Publications Warehouse

Harp, Edwin L.; Jibson, Randall W.; Schmitt, Robert G.

2016-04-12

The magnitude (M) 7.0 Haiti earthquake of January 12, 2010, triggered landslides throughout much of Haiti on the island of Hispaniola in the Caribbean Sea. The epicenter of the quake was located at 18.44°N., 72.57°W. at a depth of 13 kilometers (km) approximately 25 km southwest of the capital, Port-au-Prince. Although estimates vary widely, the most reliable surveys of casualties indicate that the earthquake caused 158,679 fatalities and more than 300,000 injuries. The U.S. Geological Survey compared publicly available satellite imagery acquired both before and after the earthquake and mapped 23,567 landslides that were triggered by the strong shaking. Our mapping from aerial photography and satellite imagery was augmented by field observations.Most of the landslides triggered by the earthquake were south of the Léogâne fault on the footwall and were fairly shallow falls and slides in weathered limestone (2–5 meters [m] thick) and volcanic rock and soil (generally <1 m thick). Landslides extended from the north to the south coasts of the southwestern peninsula (southwest of Port-au-Prince) and almost 60 km to the east and west of the epicenter. The highest concentration of landslides was on the steep limestone slopes of incised river valleys, but large numbers of landslides also occurred on gentler slopes in weathered volcanic rocks. Although some high landslide concentrations did occur near areas of maximum fault slip, the overall distribution of landslides appears to involve complex interactions between geology, topography, and strong shaking with limited spatial correlation between fault slip and landslides.

Transmission of Zika Virus - Haiti, October 12, 2015-September 10, 2016.

PubMed

Journel, Ito; Andrécy, Lesly L; Metellus, Dudley; Pierre, Jean S; Faublas, Rose Murka; Juin, Stanley; Dismer, Amber M; Fitter, David L; Neptune, Daniel; Laraque, Marie José; Corvil, Salomon; Pierre, Manise; Buteau, Josiane; Lafontant, Donald; Patel, Roopal; Lemoine, Jean Frantz; Lowrance, David W; Charles, Macarthur; Boncy, Jacques; Adrien, Paul

2017-02-17

Zika virus disease is caused by infection with a flavivirus with broad geographic distribution and is most frequently transmitted by the bite of an infected mosquito. The disease was first identified in the World Health Organization's Region of the Americas in 2015 and was followed by a surge in reported cases of congenital microcephaly in Brazil; Zika virus disease rapidly spread to the rest of the region and the Caribbean (1), including Haiti. Infection with the virus is associated with adverse fetal outcomes (1) and rare neurologic complications in adults. The magnitude of public health issues associated with Zika virus led the World Health Organization to declare the Zika virus outbreak a Public Health Emergency of International Concern on February 1, 2016 (2). Because many persons with mild Zika virus disease are asymptomatic and might not seek care, it is difficult to estimate the actual incidence of Zika virus infection. During October 12, 2015-September 10, 2016, the Haitian Ministry of Public Health and Population (Ministère de la Santé Publique et de la Population [MSPP]) detected 3,036 suspected cases of Zika virus infection in the general population, 22 suspected cases of Zika virus disease among pregnant women, 13 suspected cases of Guillain-Barré syndrome (GBS), and 29 suspected cases of Zika-associated congenital microcephaly. Nineteen (0.6%) patients with suspected Zika virus disease, residing in Ouest (10 patients), Artibonite (six), and Centre (three) administrative departments,* have been confirmed by laboratory testing, including two among pregnant women and 17 in the general population. Ongoing laboratory-enhanced surveillance to monitor Zika virus disease in Haiti is important to understanding the outbreak and ensuring effective response activities.

Cost-Effectiveness Evaluation of a Novel Integrated Bite Case Management Program for the Control of Human Rabies, Haiti 2014-2015.

PubMed

Undurraga, Eduardo A; Meltzer, Martin I; Tran, Cuc H; Atkins, Charisma Y; Etheart, Melissa D; Millien, Max F; Adrien, Paul; Wallace, Ryan M

2017-06-01

AbstractHaiti has the highest burden of rabies in the Western hemisphere, with 130 estimated annual deaths. We present the cost-effectiveness evaluation of an integrated bite case management program combining community bite investigations and passive animal rabies surveillance, using a governmental perspective. The Haiti Animal Rabies Surveillance Program (HARSP) was first implemented in three communes of the West Department, Haiti. Our evaluation encompassed all individuals exposed to rabies in the study area ( N = 2,289) in 2014-2015. Costs (2014 U.S. dollars) included diagnostic laboratory development, training of surveillance officers, operational costs, and postexposure prophylaxis (PEP). We used estimated deaths averted and years of life gained (YLG) from prevented rabies as health outcomes. HARSP had higher overall costs (range: $39,568-$80,290) than the no-bite-case-management (NBCM) scenario ($15,988-$26,976), partly from an increased number of bite victims receiving PEP. But HARSP had better health outcomes than NBCM, with estimated 11 additional annual averted deaths in 2014 and nine in 2015, and 654 additional YLG in 2014 and 535 in 2015. Overall, HARSP was more cost-effective (US$ per death averted) than NBCM (2014, HARSP: $2,891-$4,735, NBCM: $5,980-$8,453; 2015, HARSP: $3,534-$7,171, NBCM: $7,298-$12,284). HARSP offers an effective human rabies prevention solution for countries transitioning from reactive to preventive strategies, such as comprehensive dog vaccination.

Cross-sectional analysis of the association between bedtime and malaria exposure in the Ouest and Sud-Est Departments of Haiti.

PubMed

Stephenson, Caroline J; Rossheim, Matthew E; Frankenfeld, Cara L; Boncy, Jacques; Okech, Bernard A; von Fricken, Michael E

2017-12-01

The governments of Haiti and the Dominican Republic have a binational agreement to work towards malaria elimination for the island of Hispaniola by the year 2020. Understanding malaria-related knowledge and behaviors can help inform elimination efforts. This study examined the association between social-behavioral factors, like bedtime and bed net ownership, with malaria seroconversion status among people in the Ouest and Sud-Est departments of Haiti. In 2013, cross-sectional survey data (n=377) and blood samples were collected from a convenience sample of individuals within community, clinic and school settings. Logistic regression models were constructed to examine associations between social-behavioral factors and malaria exposure, adjusting for potential confounders. Compared to people going to bed between 6 and 8 pm, those going to bed between 8 and 10 pm were 2.67 (OR, 95% CI: 1.16-6.14) times as likely to have been exposed to malaria. Participants who reported going to bed after 10 pm were 5.96 times as likely to have had previous malaria exposure (OR, 95% CI: 2.26-15.7), compared to 6-8 pm. No significant associations were found between malaria exposure and either insecticide use nor bed net ownership. These findings are consistent with suspected feeding behaviors of Anopheles albimanus, which prefers feeding at night and outdoors. Study findings may improve overall understanding of malaria transmission in Haiti and potentially guide future studies conducted in this region. Copyright © 2017 Elsevier B.V. All rights reserved.

Te Tremble: An Unnatural Disaster--A Trial Role Play Probes the Roots of Devastation in Haiti

ERIC Educational Resources Information Center

Sanchez, Adam

2011-01-01

When the author first heard that the earthquake that hit Haiti destroyed entire Haitian cities and killed more than a quarter million people, he was shocked. For him, it was apparent that this was more than a natural disaster. As he learned about the role the U.S. government had played in Haitian affairs--the multiple occupations, the support for…

Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Ouest and Sud-Est departments of Haiti.

PubMed

von Fricken, Michael E; Weppelmann, Thomas A; Eaton, Will T; Alam, Meer T; Carter, Tamar E; Schick, Laura; Masse, Roseline; Romain, Jean R; Okech, Bernard A

2014-07-01

Malaria remains a significant public health issue in Haiti, with chloroquine (CQ) used almost exclusively for the treatment of uncomplicated infections. Recently, single dose primaquine (PQ) was added to the Haitian national malaria treatment policy, despite a lack of information on the prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency within the population. G6PD deficient individuals who take PQ are at risk of developing drug induced hemolysis (DIH). In this first study to examine G6PD deficiency rates in Haiti, 22.8% (range 14.9%-24.7%) of participants were found to be G6PD deficient (class I, II, or III) with 2.0% (16/800) of participants having severe deficiency (class I and II). Differences in deficiency were observed by gender, with males having a much higher prevalence of severe deficiency (4.3% vs. 0.4%) compared to females. Male participants were 1.6 times more likely to be classified as deficient and 10.6 times more likely to be classified as severely deficient compared to females, as expected. Finally, 10.6% (85/800) of the participants were considered to be at risk for DIH. Males also had much higher rates than females (19.3% vs. 4.6%) with 4.9 times greater likelihood (p value 0.000) of having an activity level that could lead to DIH. These findings provide useful information to policymakers and clinicians who are responsible for the implementation of PQ to control and manage malaria in Haiti. Copyright © 2014 Elsevier B.V. All rights reserved.

Medical and psychosocial needs of Olympic and Pan American athletes after the 2010 earthquake in Haiti: an opportunity to promote resilience through sports medicine and public diplomacy.

PubMed

Yim, Eugene S; Macy, Robert D; Ciottone, Gregory

2014-04-01

On January 12, 2010, a magnitude 7.0 earthquake devastated Haiti. Data regarding the prevalence of medical and psychosocial needs after the earthquake is scarce, complicating informed targeting of aid. The effects of the earthquake on athletes, as they differ from the general population, are especially unclear. The Center for Disaster Resilience (Boston, Massachusetts USA) and the Disaster Medicine Section at Harvard Medical School (Boston, Massachusetts USA) have partnered with Child in Hand to care for athletes training for the Pan American and Olympic games in Haiti, as well as for children from the general population. This report presents preliminary epidemiologic data illustrating the burden of medical and psychosocial needs of Haitian athletes and the general population after the earthquake of 2010. The study was a cross-sectional, comparative study conducted a year after the earthquake. The study group comprised 104 athletes, aged 12-18 years, enrolled from the National Sports Center in Haiti. The control group (N = 104) from the general population was age- and gender-matched from orphanages and schools in and around Port-au-Prince, Haiti. Medical teams assessed illness based on history and physicals. Psychosocial teams utilized the Child Psychosocial Distress Screener (CPDS). Two-proportion z tests and two-sample t tests were used to compare the proportions of medical illnesses, mean CPDS scores, and proportion of CPDS scores indicating treatment. The most prevalent medical condition in athletes was musculoskeletal pain, which was more common than in controls (49% versus 2.9%). All other medical conditions were more common in the controls than athletes: abdominal pain (28.8% versus 4.8%); headache (22.1% versus 5.8%); fever (15.4% versus 1%); and malnutrition (18.3% versus 1.9%). In contrast, there was no significant difference in mean psychosocial scores and the proportion of scores indicating treatment between athletes and controls. Elite athletes in

Tektites in cretaceous-tertiary boundary rocks on Haiti and their bearing on the Alvarez impact extinction hypothesis

NASA Astrophysics Data System (ADS)

Izett, G. A.

1991-11-01

Observational and geochemical data for glass objects recently discovered, by Izett et al. (1990), in K-T boundary rocks on the island of Haiti are presented. The presence of tektites, which are of terrestrial impact origin, in the same bed with a Pt-metal abundance anomaly and shocked mineral grains enormously strengthens the impact component of the Alvarez K-T impact extinction hypothesis. Shocked quartz grains in samples of the Haitian K-T boundary marker bed are about the same size as those at the K-T boundary sites in western North America. Petrographic observations indicate that the K-T marker bed on Haiti is not a primary air fall unit composed entirely of impact ejecta. It contains a small volcanogenic component of locally derived material admixed with the impact ejecta during deposition on the seafloor. The major and trace element composition of the Haitian tektites, in particular, the high Rb and REE content, suggests that the target material melted during the K-T impact was sedimentary with an average composition of andesite, not mafic or ultramafic oceanic crust.

Improving the resolution of the 2010 Haiti earthquake fault geometry using temporary seismometer deployments

NASA Astrophysics Data System (ADS)

Douilly, R.; Haase, J. S.; Ellsworth, W. L.; Bouin, M.; Calais, E.; Armbruster, J. G.; Mercier De Lepinay, B. F.; Deschamps, A.; Saint Louis, M.; Meremonte, M. E.; Hough, S. E.

2011-12-01

Haiti has several active faults that are capable of producing large earthquakes such as the 2010 Mw 7.0 Haiti earthquake. This earthquake was not unexpected, given geodetic measurements showing strain accumulation on the Enriquillo Plantain Garden Fault Zone, the major fault system in southern Haiti (Manaker et al. 2008). GPS and INSAR data (Calais et al., 2010) show, however, that this rupture occurred on the previously unmapped Léogâne fault, a 60° north dipping oblique blind thrust located immediately north of the Enriquillo Fault. Following the earthquake, several groups installed temporary seismic stations to record aftershocks. Natural Resources Canada installed three broadband seismic stations, Géoazur installed 21 ocean bottom seismometers, L'Institut de Physique du Globe de Paris installed 5 broadband seismometers, and the United States Geological Survey deployed 17 short period and strong motion seismometers in and around Port-au-Prince. We use data from this complete set of stations, along with data from permanent regional stations, to relocate all of the events from March 17 to June 24, to determine the regional one-dimensional crustal structure and determine focal mechanisms. The aftershock locations from the combined data set clearly delineate the Léogâne fault. The strike and dip closely agrees with that of the global centroid moment tensor solution, but appears to be more steeply dipping than the finite fault inversions. The aftershocks also delineate a flat structure on the west side of the rupture zone and may indicate triggered seismicity on the Trois Baies fault, although the depths of these events are not as well constrained. There is no clear evidence for aftershocks on the other rupture segments inferred in the Hayes et al. (2010) mainshock rupture model. There is a cluster of aftershocks in the hanging wall near the western patch of high slip identified by Calais et al. (2010) and Meng et al. (2011), or central patch in the Hayes et al

Using high resolution satellite multi-temporal interferometry for landslide hazard detection in tropical environments: the case of Haiti

NASA Astrophysics Data System (ADS)

Wasowski, Janusz; Nutricato, Raffaele; Nitti, Davide Oscar; Bovenga, Fabio; Chiaradia, Maria Teresa; Piard, Boby Emmanuel; Mondesir, Philemon

2015-04-01

Synthetic aperture radar (SAR) multi-temporal interferometry (MTI) is one of the most promising satellite-based remote sensing techniques for fostering new opportunities in landslide hazard detection and assessment. MTI is attractive because it can provide very precise quantitative information on slow slope displacements of the ground surface over huge areas with limited vegetation cover. Although MTI is a mature technique, we are only beginning to realize the benefits of the high-resolution imagery that is currently acquired by the new generation radar satellites (e.g., COSMO-SkyMed, TerraSAR-X). In this work we demonstrate the potential of high resolution X-band MTI for wide-area detection of slope instability hazards even in tropical environments that are typically very harsh (eg. coherence loss) for differential interferometry applications. This is done by presenting an example from the island of Haiti, a tropical region characterized by dense and rapidly growing vegetation, as well as by significant climatic variability (two rainy seasons) with intense precipitation events. Despite the unfavorable setting, MTI processing of nearly 100 COSMO-SkyMed (CSK) mages (2011-2013) resulted in the identification of numerous radar targets even in some rural (inhabited) areas thanks to the high resolution (3 m) of CSK radar imagery, the adoption of a patch wise processing SPINUA approach and the presence of many man-made structures dispersed in heavily vegetated terrain. In particular, the density of the targets resulted suitable for the detection of some deep-seated and shallower landslides, as well as localized, very slow slope deformations. The interpretation and widespread exploitation of high resolution MTI data was facilitated by Google EarthTM tools with the associated high resolution optical imagery. Furthermore, our reconnaissance in situ checks confirmed that MTI results provided useful information on landslides and marginally stable slopes that can represent a

Disaster mobile health technology: lessons from Haiti.

PubMed

Callaway, David W; Peabody, Christopher R; Hoffman, Ari; Cote, Elizabeth; Moulton, Seth; Baez, Amado Alejandro; Nathanson, Larry

2012-04-01

Mobile health (mHealth) technology can play a critical role in improving disaster victim tracking, triage, patient care, facility management, and theater-wide decision-making. To date, no disaster mHealth application provides responders with adequate capabilities to function in an austere environment. The Operational Medicine Institute (OMI) conducted a qualitative trial of a modified version of the off-the-shelf application iChart at the Fond Parisien Disaster Rescue Camp during the large-scale response to the January 12, 2010 earthquake in Haiti. The iChart mHealth system created a patient log of 617 unique entries used by on-the-ground medical providers and field hospital administrators to facilitate provider triage, improve provider handoffs, and track vulnerable populations such as unaccompanied minors, pregnant women, traumatic orthopedic injuries and specified infectious diseases. The trial demonstrated that even a non-disaster specific application with significant programmatic limitations was an improvement over existing patient tracking and facility management systems. A unified electronic medical record and patient tracking system would add significant value to first responder capabilities in the disaster response setting.

Retention in Care among HIV-Infected Pregnant Women in Haiti with PMTCT Option B.

PubMed

Dionne-Odom, Jodie; Massaro, Courtney; Jogerst, Kristen M; Li, Zhongze; Deschamps, Marie-Marcelle; Destine, Cleonas Junior; Senecharles, Redouin; Aristhene, Moleine Moles; Domercant, Joseph Yves; Rouzier, Vanessa; Wright, Peter F

2016-01-01

Background. Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding. Methods. Retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU) defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing. Results. Women in the cohort had 463 pregnancies between 2009 and 2012 with retention rates of 80% at delivery, 67% at one year, and 59% at 2 years. Among those who were LFU, the highest risk period was during pregnancy (60%) or shortly afterwards (24.4% by 12 months). Never starting on antiretroviral therapy (aRR 2.29, 95% CI 1.4-3.8) was associated with loss to follow-up. Conclusions. Loss to follow-up during and after pregnancy was common in HIV-infected women in Haiti under PMTCT Option B. Since sociodemographic factors and distance from home to facility did not predict LFU, future work should elicit and address barriers to retention at the initial prenatal care visit in all women. Better tracking systems to capture engagement in care in the wider network are needed.

Retention in Care among HIV-Infected Pregnant Women in Haiti with PMTCT Option B

PubMed Central

Massaro, Courtney; Li, Zhongze; Deschamps, Marie-Marcelle; Destine, Cleonas Junior; Senecharles, Redouin; Aristhene, Moleine Moles; Domercant, Joseph Yves; Rouzier, Vanessa; Wright, Peter F.

2016-01-01

Background. Preventing mother-to-child transmission of HIV relies on engagement in care during the prenatal, peripartum, and postpartum periods. Under PMTCT Option B, pregnant women with elevated CD4 counts are provided with antiretroviral prophylaxis until cessation of breastfeeding. Methods. Retrospective analysis of retention in care among HIV-infected pregnant women in Haiti was performed. Logistic regression was used to identify risk factors associated with loss to follow-up (LFU) defined as no medical visit for at least 6 months and Kaplan-Meier curves were created to show LFU timing. Results. Women in the cohort had 463 pregnancies between 2009 and 2012 with retention rates of 80% at delivery, 67% at one year, and 59% at 2 years. Among those who were LFU, the highest risk period was during pregnancy (60%) or shortly afterwards (24.4% by 12 months). Never starting on antiretroviral therapy (aRR 2.29, 95% CI 1.4–3.8) was associated with loss to follow-up. Conclusions. Loss to follow-up during and after pregnancy was common in HIV-infected women in Haiti under PMTCT Option B. Since sociodemographic factors and distance from home to facility did not predict LFU, future work should elicit and address barriers to retention at the initial prenatal care visit in all women. Better tracking systems to capture engagement in care in the wider network are needed. PMID:27651953

Characteristics and Spectrum of Disease Among Ill Returned Travelers from Pre- and Post-Earthquake Haiti: The GeoSentinel Experience

PubMed Central

Esposito, Douglas H.; Han, Pauline V.; Kozarsky, Phyllis E.; Walker, Patricia F.; Gkrania-Klotsas, Effrossyni; Barnett, Elizabeth D.; Libman, Michael; McCarthy, Anne E.; Field, Vanessa; Connor, Bradley A.; Schwartz, Eli; MacDonald, Susan; Sotir, Mark J.

2012-01-01

To describe patient characteristics and disease spectrum among foreign visitors to Haiti before and after the 2010 earthquake, we used GeoSentinel Global Surveillance Network data and compared 1 year post-earthquake versus 3 years pre-earthquake. Post-earthquake travelers were younger, predominantly from the United States, more frequently international assistance workers, and more often medically counseled before their trip than pre-earthquake travelers. Work-related stress and upper respiratory tract infections were more frequent post-earthquake; acute diarrhea, dengue, and Plasmodium falciparum malaria were important contributors of morbidity both pre- and post-earthquake. These data highlight the importance of providing destination- and disaster-specific pre-travel counseling and post-travel evaluation and medical management to persons traveling to or returning from a disaster location, and evaluations should include attention to the psychological wellbeing of these travelers. For travel to Haiti, focus should be on mosquito-borne illnesses (dengue and P. falciparum malaria) and travelers' diarrhea. PMID:22232445

Deep Tectonic Tremor in Haiti triggered by the 2010/02/27 Mw8.8 Maule, Chile earthquake

NASA Astrophysics Data System (ADS)

Aiken, C.; Peng, Z.; Douilly, R.; Calais, E.; Deschamps, A.; Haase, J. S.

2013-05-01

Tectonic tremors have been observed along major plate-boundary faults around the world. In most of these regions, tremors occur spontaneously (i.e. ambient) or as a result of small stress perturbations from passing surface waves (i.e. triggered). Because tremors are located below the seismogenic zone, a detailed study of their behavior could help to better understand how tectonic movement is accommodated in the deep root of major faults, and the relationship with large earthquakes. Here, we present evidence of triggered tremor in southern Haiti around the aftershock zone of the 2010/01/12 Mw7.0 Haiti earthquake. Following the January mainshock, several groups have installed land and ocean bottom seismometers to record aftershock activity (e.g., De Lepinay et al., 2011). In the following month, the 2010/02/27 Mw8.8 Maule, Chile earthquake occurred and was recorded in the southern Haiti region by these seismic stations. We apply a 5-15 Hz band-pass filter to all seismograms to identify local high-frequency signals during the Chile teleseismic waves. Tremor is identified as non-impulsive bursts with 10-20 s durations that is coherent among different stations and is modulated by surface waves. We also convert the seismic data into audible sounds and use them to distinguish between local aftershocks and deep tremor. We locate the source of the tremor bursts using an envelope cross-correlation method based on travel time differences. Because tremor depth is not well constrained with this method, we set it to 20 km, close to the recent estimate of Moho depth in this region (McNamara et al., 2012). Most tremors are located south of the surface expression of the Enriquillo-Plantain Garden Fault (EPGF), a high-angle southward dipping left-lateral strike-slip fault that marks the boundary between the Gonave microplate and the Caribbean plate, although the location errors are large. Tremor peaks are mostly modulated by Love wave velocity, which is consistent with left

The fourth delay and community-driven solutions to reduce maternal mortality in rural Haiti: a community-based action research study.

PubMed

MacDonald, Tonya; Jackson, Suzanne; Charles, Marie-Carmèle; Periel, Marius; Jean-Baptiste, Marie-Véna; Salomon, Alex; Premilus, Éveillard

2018-06-20

In Haiti, the number of women dying in pregnancy, during childbirth and the weeks after giving birth remains unacceptably high. The objective of this research was to explore determinants of maternal mortality in rural Haiti through Community-Based Action Research (CBAR), guided by the delays that lead to maternal death. This paper focuses on socioecological determinants of maternal mortality from the perspectives of women of near-miss maternal experiences and community members, and their solutions to reduce maternal mortality in their community. The study draws on five semi-structured Individual Interviews with women survivors of near-misses, and on four Focus Group Discussions with Community Leaders and with Traditional Birth Attendants. Data collection took place in July 2013. A Community Research Team within a resource-limited rural community in Haiti undertook the research. The methods and analysis process were guided by participatory research and CBAR. Participants identified three delays that lead to maternal death but also described a fourth delay with respect to community responsibility for maternal mortality. They included women being carried from the community to a healthcare facility as a special example of the fourth delay. Women survivors of near-miss maternal experiences and community leaders suggested solutions to reduce maternal death that centered on prevention and community infrastructure. Most of the strategies for action were related to the fourth delay and include: community mobilization by way of the formation of Neighbourhood Maternal Health/Well-being Committees, and community support through the provision/sharing of food for undernourished women, offering monetary support and establishment of a communication relay/transport system in times of crisis. Finding sustainable ways to reduce maternal mortality requires a community-based/centred and community-driven comprehensive approach to maternal health/well-being. This includes engagement of

Cost-Effectiveness Evaluation of a Novel Integrated Bite Case Management Program for the Control of Human Rabies, Haiti 2014–2015

PubMed Central

Undurraga, Eduardo A.; Meltzer, Martin I.; Tran, Cuc H.; Atkins, Charisma Y.; Etheart, Melissa D.; Millien, Max F.; Adrien, Paul; Wallace, Ryan M.

2017-01-01

Haiti has the highest burden of rabies in the Western hemisphere, with 130 estimated annual deaths. We present the cost-effectiveness evaluation of an integrated bite case management program combining community bite investigations and passive animal rabies surveillance, using a governmental perspective. The Haiti Animal Rabies Surveillance Program (HARSP) was first implemented in three communes of the West Department, Haiti. Our evaluation encompassed all individuals exposed to rabies in the study area (N = 2,289) in 2014–2015. Costs (2014 U.S. dollars) included diagnostic laboratory development, training of surveillance officers, operational costs, and postexposure prophylaxis (PEP). We used estimated deaths averted and years of life gained (YLG) from prevented rabies as health outcomes. HARSP had higher overall costs (range: $39,568–$80,290) than the no-bite-case-management (NBCM) scenario ($15,988–$26,976), partly from an increased number of bite victims receiving PEP. But HARSP had better health outcomes than NBCM, with estimated 11 additional annual averted deaths in 2014 and nine in 2015, and 654 additional YLG in 2014 and 535 in 2015. Overall, HARSP was more cost-effective (US$ per death averted) than NBCM (2014, HARSP: $2,891–$4,735, NBCM: $5,980–$8,453; 2015, HARSP: $3,534–$7,171, NBCM: $7,298–$12,284). HARSP offers an effective human rabies prevention solution for countries transitioning from reactive to preventive strategies, such as comprehensive dog vaccination. PMID:28719253

Healthcare waste management during disasters and its effects on climate change: Lessons from 2010 earthquake and cholera tragedies in Haiti.

PubMed

Raila, Emilia M; Anderson, David O

2017-03-01

Despite growing effects of human activities on climate change throughout the world, and global South in particular, scientists are yet to understand how poor healthcare waste management practices in an emergency influences the climate change. This article presents new findings on climate change risks of healthcare waste disposal during and after the 2010 earthquake and cholera disasters in Haiti. The researchers analysed quantities of healthcare waste incinerated by the United Nations Mission in Haiti for 60 months (2009 to 2013). The aim was to determine the relationship between healthcare waste incinerated weights and the time of occurrence of the two disasters, and associated climate change effects, if any. Pearson product-moment correlation coefficient indicated a weak correlation between the quantities of healthcare waste disposed of and the time of occurrence of the actual emergencies (r (58) = 0.406, p = 0.001). Correspondingly, linear regression analysis indicated a relatively linear data trend (R 2 = 0.16, F (1, 58) = 11.42, P = 0.001) with fluctuating scenarios that depicted a sharp rise in 2012, and time series model showed monthly and yearly variations within 60 months. Given that the peak healthcare waste incineration occurred 2 years after the 2010 disasters, points at the need to minimise wastage on pharmaceuticals by improving logistics management. The Government of Haiti had no data on healthcare waste disposal and practised smoky open burning, thus a need for capacity building on green healthcare waste management technologies for effective climate change mitigation.

The use of psychosocial assessment following the Haiti earthquake in the development of the three-year emotional psycho-medical mental health and psychosocial support (EP-MMHPS) plan.

PubMed

Jordan, Karin

2010-01-01

This article provides information about the 2010 Haiti earthquake. An assessment model used by a crisis counselor responding to the earthquake is presented, focusing on the importance of gathering pre-deployment assessment and in-country assessment. Examples of the information gathered through the in-country assessment model from children, adolescents, and adults are presented. A brief overview of Haiti's three-year Emergency Psycho-Medical Mental Health and Psychosocial Support (EP-MMHPS) is provided. Finally, how the psychosocial manual developed after assessing 200 Haitian survivors through in-country assessment, and information gathered through pre-deployment assessment became part of the EP-MMHPS is offered.

Evaluation of case management of uncomplicated malaria in Haiti: a national health facility survey, 2012.

PubMed

Landman, Keren Z; Jean, Samuel E; Existe, Alexandre; Akom, Eniko E; Chang, Michelle A; Lemoine, Jean Frantz; Mace, Kimberly E

2015-10-09

Malaria is a public health concern in Haiti, although there are limited data on its burden and case management. National malaria guidelines updated in 2012 recommend treatment with chloroquine and primaquine. In December 2012, a nationally-representative cross-sectional survey of health facilities (HFs) was conducted to determine malaria prevalence among febrile outpatients and malaria case management quality at baseline before scale-up of diagnostics and case management training. Among all 833 HFs nationwide, 30 were selected randomly, in proportion to total HFs per region, for 2-day evaluations. Survey teams inventoried HF material and human resources. Outpatients of all ages were screened for temperature >37.5 °C or history of fever; those without severe symptoms were consented and enrolled. Providers evaluated and treated enrolled patients according to HF standards; the survey teams documented provider-ordered diagnostic tests and treatment decisions. Facility-based test results [microscopy and malaria rapid diagnostic tests (RDTs)] were collected from HF laboratories. Blood smears for gold-standard microscopy, and dried blood spots for polymerase chain reaction (PCR) were obtained. Malaria diagnostic capacity, defined as completing a test for an enrolled patient or having adequate resources for RDTs or microscopy, was present in 11 (37 %) HFs. Among 459 outpatients screened, 257 (56 %) were febrile, of which 193 (75 %) were eligible, and 153 (80 %) were enrolled. Among 39 patients with facility-level malaria test results available on the survey day, 11 (28 %) were positive, of whom 6 (55 %) were treated with an anti-malarial. Twenty-seven (95 %) of the 28 patients testing negative were not treated with an anti-malarial. Of 114 patients without test results available, 35 (31 %) were presumptively treated for malaria. Altogether, 42 patients were treated with an anti-malarial, one (2 %) according to Haiti's 2012 guidelines. Of 140 gold-standard smears, none

Factors associated with forced sex among women accessing health services in rural Haiti: implications for the prevention of HIV infection and other sexually transmitted diseases.

PubMed

Smith Fawzi, M C; Lambert, W; Singler, J M; Tanagho, Y; Léandre, F; Nevil, P; Bertrand, D; Claude, M S; Bertrand, J; Louissaint, M; Jeannis, L; Mukherjee, J S; Goldie, S; Salazar, J J; Farmer, P E

2005-02-01

The goals of the current study were to: (1) estimate the prevalence of forced sex among women accessing services at a women's health clinic in rural Haiti; and (2) examine factors associated with forced sex in this population. Based on data from a case-control study of risk factors for sexually transmitted diseases (STDs), a cross-sectional analysis to examine factors associated with forced sex was performed. A number of factors related to gender inequality/socioeconomic vulnerability placed women in rural Haiti at higher risk of forced sex. The strongest factors associated with forced sex in multivariate analyses were: age, length of time in a relationship, occupation of the woman's partner, STD-related symptoms, and factors demonstrating economic vulnerability. The findings suggest that prevention efforts must go beyond provision of information and education to the pursuit of broader initiatives at both local and national levels. At the community level, policy-makers should consider advancing economic opportunities for women who are vulnerable to forced sex. Improving access to community-based income-generating activities may begin to address this problem. However, the viability of these local projects depends largely upon Haiti's 'macro-economic' situation. In order to ensure the success of local initiatives, external humanitarian and development assistance to Haiti should be supported. By broadening the definition of "prevention" interventions, we may begin to address the systemic problems that contribute to the occurrence of forced sex and the increasing incidence of HIV infection throughout the world, such as gender inequality and economic vulnerability. Taking into account factors influencing risk at the local level as well as the macro-level will potentially improve our capacity to reduce the risk of forced sex and the spread of STDs, including HIV infection, for millions of women living in poverty worldwide.

Exploring Child Mortality Risks Associated with Diverse Patterns of Maternal Migration in Haiti

PubMed Central

Smith-Greenaway, Emily; Thomas, Kevin

2014-01-01

Internal migration is a salient dimension of adulthood in Haiti, particularly among women. Despite the prevalence of migration in Haiti, it remains unknown whether Haitian women’s diverse patterns of migration influence their children’s health and survival. In this paper, we introduce the concept of lateral (i.e., rural-to-rural, urban-to-urban) versus nonlateral (i.e., rural-to-urban, urban-to-rural) migration to describe how some patterns of mothers’ internal migration may be associated with particularly high mortality among children. We use the 2006 Haitian Demographic and Health Survey to estimate a series of discrete-time hazard models among 7,409 rural children and 3,864 urban children. We find that, compared with their peers with nonmigrant mothers, children born to lateral migrants generally experience lower mortality whereas those born to nonlateral migrants generally experience higher mortality. Although there are important distinctions across Haiti’s rural and urban contexts, these associations remain net of socioeconomic factors, suggesting they are not entirely attributable to migrant selection. Considering the timing of maternal migration uncovers even more variation in the child health implications of maternal migration; however, the results counter the standard disruption and adaptation perspective. Although future work is needed to identify the processes underlying the differential risk of child mortality across lateral versus nonlateral migrants, the study demonstrates that looking beyond rural-to-urban migration and considering the timing of maternal migration can provide a fuller, more complex understanding of migration’s association with child health. PMID:25506111

New baseline environmental assessment of mosquito ecology in northern Haiti during increased urbanization

PubMed Central

Archer, Reginald S.; Alimi, Temitope O.; Arheart, Kristopher K.; Impoinvil, Daniel E.; Oscar, Roland; Fuller, Douglas O.; Qualls, Whitney A.

2015-01-01

The catastrophic 2010 earthquake in Port-au-Prince, Haiti, led to the large-scale displacement of over 2.3 million people, resulting in rapid and unplanned urbanization in northern Haiti. This study evaluated the impact of this unplanned urbanization on mosquito ecology and vector-borne diseases by assessing land use and change patterns. Land-use classification and change detection were carried out on remotely sensed images of the area for 2010 and 2013. Change detection identified areas that went from agricultural, forest, or bare-land pre-earthquake to newly developed and urbanized areas post-earthquake. Areas to be sampled for mosquito larvae were subsequently identified. Mosquito collections comprised five genera and ten species, with the most abundant species being Culex quinquefasciatus 35% (304/876), Aedes albopictus 27% (238/876), and Aedes aegypti 20% (174/876). All three species were more prevalent in urbanized and newly urbanized areas. Anopheles albimanus, the predominate malaria vector, accounted for less than 1% (8/876) of the collection. A set of spectral indices derived from the recently launched Landsat 8 satellite was used as covariates in a species distribution model. The indices were used to produce probability surfaces maps depicting the likelihood of presence of the three most abundant species within 30 m pixels. Our findings suggest that the rapid urbanization following the 2010 earthquake has increased the amount of area with suitable habitats for urban mosquitoes, likely influencing mosquito ecology and posing a major risk of introducing and establishing emerging vector-borne diseases. PMID:26047183

Epidemiology of Traumatic Injuries at an Urban Hospital in Port-au-Prince, Haiti.

PubMed

Zuraik, Christopher; Sampalis, John

2017-11-01

Traumatic injuries represent a major burden of disease worldwide. Haiti lacks statistics on the epidemiology of traumatic injuries, as there is no formal injury surveillance program. This study will assess the burden of traumatic injuries in an urban trauma center in the capital city of Port-au-Prince, Haiti. A retrospective, cross-sectional chart review study at an urban trauma hospital was carried out for the period December 1, 2015, to January 31, 2016. Data were obtained through the hospital's main patient logbook, medical charts, and trauma registry forms. Data on medical documentation, demographics, and injury characteristics were collected and analyzed using descriptive statistics. A total of 410 patients were evaluated for treatment of traumatic injuries during the 2-month study. The mean age in years was 30, with 66.3% male and 78.4% less than 41 years of age. There were 6.6 injuries per day and no correlation between frequency of injury and day of the week. Road traffic accidents accounted for 43.0% of trauma modes. The mean and median length of stay were 6.6 and 3.0 days. 9.0% of patients suffered severe trauma (ISS ≥ 16). 21.0% of patients with traumatic brain injury suffered severe head injuries. Extremity trauma was the most frequently injured anatomical region (50.0%). 22.7% of patients were admitted, and 15.1% patients underwent at least one surgical procedure. Road traffic accidents are the primary reason for injury; thus, prevention initiatives and improved trauma care may provide substantial public health benefits.

Mapping three-dimensional surface deformation caused by the 2010 Haiti earthquake using advanced satellite radar interferometry.

PubMed

Jung, Hyung-Sup; Hong, Soo-Min

2017-01-01

Mapping three-dimensional (3D) surface deformation caused by an earthquake is very important for the environmental, cultural, economic and social sustainability of human beings. Synthetic aperture radar (SAR) systems made it possible to measure precise 3D deformations by combining SAR interferometry (InSAR) and multiple aperture interferometry (MAI). In this paper, we retrieve the 3D surface deformation field of the 2010 Haiti earthquake which occurred on January 12, 2010 by a magnitude 7.0 Mw by using the advanced interferometric technique that integrates InSAR and MAI data. The surface deformation has been observed by previous researchers using the InSAR and GPS method, but 3D deformation has not been measured yet due to low interferometric coherence. The combination of InSAR and MAI were applied to the ALOS PALSAR ascending and descending pairs, and were validated with the GPS in-situ measurements. The archived measurement accuracy was as little as 1.85, 5.49 and 3.08 cm in the east, north and up directions, respectively. This result indicates that the InSAR/MAI-derived 3D deformations are well matched with the GPS deformations. The 3D deformations are expected to allow us to improve estimation of the area affected by the 2010 Haiti earthquake.

Mapping three-dimensional surface deformation caused by the 2010 Haiti earthquake using advanced satellite radar interferometry

PubMed Central

Jung, Hyung-Sup; Hong, Soo-Min

2017-01-01

Mapping three-dimensional (3D) surface deformation caused by an earthquake is very important for the environmental, cultural, economic and social sustainability of human beings. Synthetic aperture radar (SAR) systems made it possible to measure precise 3D deformations by combining SAR interferometry (InSAR) and multiple aperture interferometry (MAI). In this paper, we retrieve the 3D surface deformation field of the 2010 Haiti earthquake which occurred on January 12, 2010 by a magnitude 7.0 Mw by using the advanced interferometric technique that integrates InSAR and MAI data. The surface deformation has been observed by previous researchers using the InSAR and GPS method, but 3D deformation has not been measured yet due to low interferometric coherence. The combination of InSAR and MAI were applied to the ALOS PALSAR ascending and descending pairs, and were validated with the GPS in-situ measurements. The archived measurement accuracy was as little as 1.85, 5.49 and 3.08 cm in the east, north and up directions, respectively. This result indicates that the InSAR/MAI-derived 3D deformations are well matched with the GPS deformations. The 3D deformations are expected to allow us to improve estimation of the area affected by the 2010 Haiti earthquake. PMID:29145475

Earthquake Damage Assessment Using Objective Image Segmentation: A Case Study of 2010 Haiti Earthquake

NASA Technical Reports Server (NTRS)

Oommen, Thomas; Rebbapragada, Umaa; Cerminaro, Daniel

2012-01-01

In this study, we perform a case study on imagery from the Haiti earthquake that evaluates a novel object-based approach for characterizing earthquake induced surface effects of liquefaction against a traditional pixel based change technique. Our technique, which combines object-oriented change detection with discriminant/categorical functions, shows the power of distinguishing earthquake-induced surface effects from changes in buildings using the object properties concavity, convexity, orthogonality and rectangularity. Our results suggest that object-based analysis holds promise in automatically extracting earthquake-induced damages from high-resolution aerial/satellite imagery.

Geospatial Data Availability for Haiti: An Aid in the Development of GIS-Based Natural Resource Assessments for Conservation Planning.

Treesearch

Maya Quinones; William Gould; Carlos D. Rodriguez-Pedraza

2007-01-01

This report documents the type and source of geospatial data available for Haiti. It was compiled to serve as a resource for geographic information system (GIS)-based land management and planning. It will be useful for conservation planning, reforestation efforts, and agricultural extension projects. Our study indicates that there is a great deal of geospatial...

Isolation of Coronavirus NL63 from Blood from Children in Rural Haiti: Phylogenetic Similarities with Recent Isolates from Malaysia.

PubMed

Beau De Rochars, Valery Madsen; Lednicky, John; White, Sarah; Loeb, Julia; Elbadry, Maha A; Telisma, Taina; Chavannes, Sonese; Anilis, Marie Gina; Cella, Eleonora; Ciccozzi, Massimo; Okech, Bernard A; Salemi, Marco; Morris, J Glenn

2017-01-11

Human coronavirus (HCoV) NL63 is recognized as a common cause of upper respiratory infections and influenza-like illness. In screening children with acute undifferentiated febrile illness in a school cohort in rural Haiti, we identified HCoV-NL63 in blood samples from four children. Cases clustered over an 11-day period; children did not have respiratory symptoms, but two had gastrointestinal complaints. On phylogenetic analysis, the Haitian HCoV-NL63 strains cluster together in a highly supported monophyletic clade linked most closely with recently reported strains from Malaysia; two respiratory HCoV-NL63 strains identified in north Florida in the same general period form a separate clade, albeit again with close linkages with the Malaysian strains. Our data highlight the variety of presentations that may be seen with HCoV-NL63, and underscore the apparent ease with which CoV strains move among countries, with our data consistent with recurrent introduction of strains into the Caribbean (Haiti and Florida) from Asia. © The American Society of Tropical Medicine and Hygiene.

The impact of fathers' clubs on child health in rural Haiti.

PubMed

Sloand, Elizabeth; Astone, Nan Marie; Gebrian, Bette

2010-02-01

In recognition of the important role that fathers play in the lives of young children in Haiti, a public health organization instituted fathers' clubs in 1994 as a strategy to improve the health outcomes of children. Fathers' clubs focus on child and family health education. To evaluate the effectiveness of fathers' clubs, we examined the health of children born in Haitian villages with and without active fathers' clubs and compared results for the two groups. The presence of a fathers' club in a child's birth village had a positive effect on vaccination status, growth monitoring, and vitamin A supplementation after we controlled for socioeconomic status, time, and the quality of the village health agent. Child weights and mortality were not affected by the fathers' clubs.

Food Insecurity, Dietary Diversity, and Body Mass Index of HIV-Infected Individuals on Antiretroviral Therapy in Rural Haiti.

PubMed

Rebick, Gabriel W; Franke, Molly F; Teng, Jessica E; Gregory Jerome, J; Ivers, Louise C

2016-05-01

Food rations are increasingly offered as part of HIV programs in resource-poor settings, often targeted solely to those with under-nutrition by low body mass index (BMI). This practice does not consider food insecurity, another important risk factor for poor outcomes in people living with HIV/AIDS (PLWH). We analyzed factors associated with low BMI and severe food insecurity in 523 PLWH receiving antiretroviral therapy in rural Haiti using logistic regression. Food insecurity was present in 89 % of individuals. Among those with severe food insecurity, 86 % had a BMI ≥ 18.5 kg/m(2). Severe food insecurity was associated with illiteracy [adjusted odds ratio (AOR) 1.79, p = 0.005], having no income (AOR 1.58, p = 0.04), and poverty (p < 0.001). Compared with those with little to no food insecurity, individuals with severe food insecurity had a less diverse diet. We found that food insecurity was highly prevalent in PLWH receiving antiretroviral therapy in rural Haiti. Using BMI as a sole criterion for food supplementation in HIV programs can exclude highly vulnerable individuals who may benefit from such support.

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study

PubMed Central

Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

2015-01-01

Background Between April and June 2012, a reactive cholera vaccination campaign was conducted in Haiti using an oral inactivated bivalent whole-cell vaccine (BivWC). Methods We conducted a case-control study to estimate field effectiveness of the vaccine. Cases had acute watery diarrhea, sought treatment at one of three participating cholera treatment units from October 24, 2012 through March 9, 2014, and had a stool sample positive for cholera by culture. For each case, four controls (individuals who did not seek treatment for acute watery diarrhea) were matched by location of residence, calendar time, and age. We also conducted a bias-indicator case-control study to assess the likelihood of bias in the vaccine effectiveness (VE) study. Findings During the study period, 114 eligible individuals presented with acute watery diarrhea and were enrolled. 47 were analyzed as cases in the VE case-control study and 42 as cases in the bias-indicator study. In multivariable analyses, VE was 63% [95% confidence interval (CI): 8%–85%] by self-reported vaccination and 58% [95% CI: 13%–80%] for verified vaccination. Neither self-reported nor verified vaccination was significantly associated with non-cholera diarrhea (VE: 18% [95% CI: −208%–−78%] by self-report and −21% [95%CI: −238%–57%] for verified vaccination). Interpretation BivWC oral cholera vaccine was effective in protecting against cholera in Haiti during the study period –from 4 through 24 months after vaccination. Vaccination is an important component of epidemic cholera control efforts. Funding National Institutes of Health, Delivering Oral Vaccines Effectively project, Department of Global Health and Social Medicine at Harvard Medical School. PMID:25701994

Risk Factors for Self-Reported Cholera Within HIV-Affected Households in Rural Haiti

PubMed Central

Cheung, Hoi Ching; Meiselbach, Mark K; Jerome, Gregory; Ternier, Ralph; Ivers, Louise C

2018-01-01

Abstract Background Cholera continues to be a major cause of morbidity and mortality worldwide and is now endemic in Haiti since first being introduced in 2010. Cholera and HIV have significant geographic overlap globally, but little is known about the clinical features and risk of cholera among HIV-infected people and their households. Methods We assessed HIV-affected households originally recruited for a randomized controlled trial of food supplements. We assessed for correlation between household and individual factors and reported history of cholera since 2010 using univariable and multivariable analyses. Results There were 352 HIV-infected household members, 32 with reported history of medically attended cholera, and 1968 other household members, 55 with reported history of medically attended cholera. Among HIV-infected individuals in this study, no variables correlated with reported history of cholera in univariable analyses. Among all household members, known HIV infection (adjusted odds ratio [AOR], 3.75; 95% CI, 2.43–5.79; P < .0001), source of income in the household (AOR, 1.82; 95% CI, 1.05–3.15; P = .034), time required to fetch water (AOR, 1.07 per 5-minute increase; 95% CI, 1.01–1.12; P = .015), and severe household food insecurity (AOR, 3.23; 95% CI, 1.25–8.34; P = .016) were correlated with reported history of cholera in a multivariable analysis. Conclusions Known HIV infection, source of household income, time required to fetch water, and severe household food insecurity were independently associated with reported history of medically attended cholera in HIV-affected households in rural Haiti. Further research is required to better understand the interactions between HIV and cholera. PMID:29942825

Factors associated with use of maternal health services in Haiti: a multilevel analysis.

PubMed

Babalola, Stella O

2014-07-01

To assess factors associated with utilization of maternal health services (MHS) among women giving birth in Haiti from 2007 - 2012. Observational data derived from the 2012 Haiti Mortality, Morbidity and Service Use Survey are analyzed. Multilevel analytic methods are used to assess factors associated with use of antenatal services and skilled birth attendance (SBA). The strongest adjusted predictors include child's birth rank, household poverty, and community media saturation. The odds of obtaining four antenatal care visits decrease by 53% (odds ratio (OR) = 0.47; 95% confidence interval (CI): 0.37-0.57) with high birth rank and by 37% (OR = 0.63; 95% CI: 0.51-0.78) with household poverty, and increase by 38% (OR = 1.38; 95% CI: 1.01-1.88) with high community media saturation. The odds of using SBA at delivery decrease by 72% (OR = 0.28; 95% CI: 0.22-0.34) with high birth rank and by 42% (OR = 0.58; 95% CI: 0.46-0.73) with household poverty, and increase by 92% (OR = 1.92; 95% CI: 1.41-2.61) with high community media saturation. Use of antenatal services is strongly associated with SBA (OR = 2.20; 95% CI: 1.85-2.61). Significant clustering of use of MHS exists at the community level. Factors associated with use of MHS operate at multiple levels. Efforts to promote such services should identify and pay special attention to the needs of multiparous and uneducated women, address the distance-decay phenomenon, and improve access for the poor. Community mobilization efforts designed to change norms hindering the use of MHS are also relevant.

Education for Citizenship in the Caribbean: A Study on Curricular Policy and Teacher Training in Cuba, Haiti and the Dominican Republic

ERIC Educational Resources Information Center

Acosta, Cheila Valera

2005-01-01

This document describes primary, secondary and teacher training curricular policy relating to education for citizenship in Cuba, Haiti and the Dominican Republic in order to make practical recommendations for improved design, quality and implementation of these initiatives in the three countries selected. The first chapter describes the Caribbean…

Phylodynamic Analysis of Clinical and Environmental Vibrio cholerae Isolates from Haiti Reveals Diversification Driven by Positive Selection

PubMed Central

Azarian, Taj; Ali, Afsar; Johnson, Judith A.; Mohr, David; Prosperi, Mattia; Veras, Nazle M.; Jubair, Mohammed; Strickland, Samantha L.; Rashid, Mohammad H.; Alam, Meer T.; Weppelmann, Thomas A.; Katz, Lee S.; Tarr, Cheryl L.; Colwell, Rita R.

2014-01-01

ABSTRACT Phylodynamic analysis of genome-wide single-nucleotide polymorphism (SNP) data is a powerful tool to investigate underlying evolutionary processes of bacterial epidemics. The method was applied to investigate a collection of 65 clinical and environmental isolates of Vibrio cholerae from Haiti collected between 2010 and 2012. Characterization of isolates recovered from environmental samples identified a total of four toxigenic V. cholerae O1 isolates, four non-O1/O139 isolates, and a novel nontoxigenic V. cholerae O1 isolate with the classical tcpA gene. Phylogenies of strains were inferred from genome-wide SNPs using coalescent-based demographic models within a Bayesian framework. A close phylogenetic relationship between clinical and environmental toxigenic V. cholerae O1 strains was observed. As cholera spread throughout Haiti between October 2010 and August 2012, the population size initially increased and then fluctuated over time. Selection analysis along internal branches of the phylogeny showed a steady accumulation of synonymous substitutions and a progressive increase of nonsynonymous substitutions over time, suggesting diversification likely was driven by positive selection. Short-term accumulation of nonsynonymous substitutions driven by selection may have significant implications for virulence, transmission dynamics, and even vaccine efficacy. PMID:25538191

Zika Virus Outbreak in Haiti in 2014: Molecular and Clinical Data

PubMed Central

Lednicky, John; Beau De Rochars, Valery Madsen; El Badry, Maha; Loeb, Julia; Telisma, Taina; Chavannes, Sonese; Anilis, Gina; Cella, Eleonora; Ciccozzi, Massimo; Rashid, Mohammed; Okech, Bernard; Salemi, Marco; Morris, J. Glenn

2016-01-01

Background Zika virus (ZIKV), first isolated in Uganda in 1947, is currently spreading rapidly through South America and the Caribbean. In Brazil, infection has been linked with microcephaly and other serious complications, leading to declaration of a public health emergency of international concern; however, there currently are only limited data on the virus (and its possible sources and manifestations) in the Caribbean. Methods From May, 2014-February, 2015, in conjunction with studies of chikungunya (CHIKV) and dengue (DENV) virus infections, blood samples were collected from children in the Gressier/Leogane region of Haiti who presented to a school clinic with undifferentiated febrile illness. Samples were initially screened by RT-PCR for CHIKV and DENV, with samples negative in these assays further screened by viral culture. Findings Of 177 samples screened, three were positive for ZIKV, confirmed by viral sequencing; DENV-1 was also identified in culture from one of the three positive case patients. Patients were from two different schools and 3 different towns, with all three cases occurring within a single week, consistent with the occurrence of an outbreak in the region. Phylogenetic analysis of known full genome viral sequences demonstrated a close relationship with ZIKV from Brazil; additional analysis of the NS5 gene, for which more sequences are currently available, showed the Haitian strains clustering within a monophyletic clade distinct from Brazilian, Puerto Rican and Guatemalan sequences, with all part of a larger clade including isolates from Easter Island. Phylogeography also clarified that at least three major African sub-lineages exist, and confirmed that the South American epidemic is most likely to have originated from an initial ZIKV introduction from French Polynesia into Easter Island, and then to the remainder of the Americas. Conclusions ZIKV epidemics in South America, as well as in Africa, show complex dissemination patterns. The

Disasters and women's health: reflections from the 2010 earthquake in Haiti.

PubMed

Bloem, Christina M; Miller, Andrew C

2013-04-01

Increasing attention is being focused on the needs of vulnerable populations during humanitarian emergency response. Vulnerable populations are those groups with increased susceptibility to poor health outcomes rendering them disproportionately affected by the event. This discussion focuses on women's health needs during the disaster relief effort after the 2010 earthquake in Haiti. The Emergency Department (ED) of the temporary mobile encampment in L'Hôpital de l'Université d'Etat d'Haïti (HUEH) was the site of the team's disaster relief mission. In February 2010, most of the hospital was staffed by foreign physicians and nurses, with a high turnover rate. Although integration with local Haitian staff was encouraged, implementation of this practice was variable. Common presentations in the ED included infectious diseases, traumatic injuries, chronic disease exacerbations, and follow-up care of post-earthquake injuries and infections. Women-specific complaints included vaginal infections, breast pain or masses, and pregnancy-related concerns or complications. Women were also targets of gender-based violence. Recent disasters in Haiti, Pakistan, and elsewhere have challenged the international health community to provide gender-balanced health care in suboptimal environments. Much room for improvement remains. Although the assessment team was gender-balanced, improved incorporation of Haitian personnel may have enhanced patient trust, and improved cultural sensitivity and communication. Camp geography should foster both patient privacy and security during sensitive examinations. This could have been improved upon by geographically separating men's and women's treatment areas and using a barrier screen to generate a more private examination environment. Women's health supplies must include an appropriate exam table, emergency obstetrical and midwifery supplies, urine dipsticks, and sanitary and reproductive health supplies. A referral system must be established for

Reassessment of the 2010–2011 Haiti cholera outbreak and rainfall-driven multiseason projections

PubMed Central

Rinaldo, Andrea; Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Blokesch, Melanie; Gatto, Marino; Casagrandi, Renato; Murray, Megan; Vesenbeckh, Silvan M.; Rodriguez-Iturbe, Ignacio

2012-01-01

Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and by anticipating the impact of alternative interventions. We study the ex post reliability of predictions of the 2010–2011 Haiti cholera outbreak from four independent modeling studies that appeared almost simultaneously during the unfolding epidemic. We consider the impact of different approaches to the modeling of spatial spread of Vibrio cholerae and mechanisms of cholera transmission, accounting for the dynamics of susceptible and infected individuals within different local human communities. To explain resurgences of the epidemic, we go on to include waning immunity and a mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission. The formal comparative analysis is carried out via the Akaike information criterion (AIC) to measure the added information provided by each process modeled, discounting for the added parameters. A generalized model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the year-long dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multiseason Monte Carlo runs, carried out up to January 2014 by using suitable rainfall fields forecasts. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control. PMID:22505737

Complex rupture mechanism and topography control symmetry of mass-wasting pattern, 2010 Haiti earthquake

NASA Astrophysics Data System (ADS)

Gorum, Tolga; van Westen, Cees J.; Korup, Oliver; van der Meijde, Mark; Fan, Xuanmei; van der Meer, Freek D.

2013-02-01

The 12 January 2010 Mw 7.0 Haiti earthquake occurred in a complex deformation zone at the boundary between the North American and Caribbean plates. Combined geodetic, geological and seismological data posited that surface deformation was driven by rupture on the Léogâne blind thrust fault, while part of the rupture occurred as deep lateral slip on the Enriquillo-Plantain Garden Fault (EPGF). The earthquake triggered > 4490 landslides, mainly shallow, disrupted rock falls, debris-soil falls and slides, and a few lateral spreads, over an area of ~ 2150 km2. The regional distribution of these slope failures defies those of most similar earthquake-triggered landslide episodes reported previously. Most of the coseismic landslides did not proliferate in the hanging wall of the main rupture, but clustered instead at the junction of the blind Léogâne and EPGF ruptures, where topographic relief and hillslope steepness are above average. Also, low-relief areas subjected to high coseismic uplift were prone to lesser hanging wall slope instability than previous studies would suggest. We argue that a combined effect of complex rupture dynamics and topography primarily control this previously rarely documented landslide pattern. Compared to recent thrust fault-earthquakes of similar magnitudes elsewhere, we conclude that lower static stress drop, mean fault displacement, and blind ruptures of the 2010 Haiti earthquake resulted in fewer, smaller, and more symmetrically distributed landslides than previous studies would suggest. Our findings caution against overly relying on across-the-board models of slope stability response to seismic ground shaking.

Patient Navigation by Community Health Workers Increases Access to Surgical Care in Rural Haiti.

PubMed

Matousek, Alexi C; Addington, Stephen R; Kahan, Joseph; Sannon, Herriot; Luckner, Thelius; Exe, Chauvet; Jean Louis, Rodolphe R Eisenhower; Lipsitz, Stuart; Meara, John G; Riviello, Robert

2017-12-01

In the Hôpital Albert Schweitzer district in rural Haiti, patients from mountain areas receive fewer operations per capita than patients from the plains. Possible additional barriers for mountain patients include lower socioeconomic status, lack of awareness of financial support, illiteracy and unfamiliarity with the hospital system. We sought to increase the rate of elective surgery for a mountain population using a patient navigation program. Patient navigators were trained to guide subjects from a mountain population through the entire hospital process for elective surgery. We compared the rate of elective operations before and after the patient navigation intervention between three groups: a control group from a mountainous area, a control group from the plains and an intervention group from a mountainous area. The baseline elective operation rate differed significantly between the plains control group, the mountain control group and the mountain intervention group (361 vs. 57 vs. 68 operations per 100,000 population per year). The rate of elective surgery between the two mountain groups was not statistically different prior to the intervention. After the intervention, the elective operation rate in the mountain group that received patient navigation increased from 68 to 131 operations per 100,000 population per year (p = 0.017). Patient navigation doubled the elective operation rate for a mountain population in rural Haiti. While additional barriers to access remain for this vulnerable population, patient navigation is an essential augmentation to financial assistance programs to ensure that the poor gain access to surgical care.

ART attrition and risk factors among Option B+ patients in Haiti: A retrospective cohort study.

PubMed

Puttkammer, Nancy; Domerçant, Jean Wysler; Adler, Michelle; Yuhas, Krista; Myrtil, Martine; Young, Paul; François, Kesner; Grand'Pierre, Reynold; Lowrance, David

2017-01-01

In October 2012, the Haitian Ministry of Health endorsed the "Option B+" strategy to eliminate mother-to-child transmission of HIV and achieve HIV epidemic control. The objective of this paper is to assess and identify risk factors for attrition from the national ART program among Option B+ patients in the 12 months after ART initiation. This retrospective cohort study included patients newly initiating ART from October 2012-August 2013 at 68 ART sites covering 45% of all newly enrolled ART patients in all regions of Haiti. With data from electronic medical records, we carried out descriptive analysis of sociodemographic, clinical, and pregnancy-related correlates of ART attrition, and used a modified Poisson regression approach to estimate relative risks in a multivariable model. There were 2,166 Option B+ patients who initiated ART, of whom 1,023 were not retained by 12 months (47.2%). One quarter (25.3%) dropped out within 3 months of ART initiation. Protective factors included older age, more advanced HIV disease progression, and any adherence counseling prior to ART initiation, while risk factors included starting ART late in gestation, starting ART within 7 days of HIV testing, and using an atypical ART regimen. Our study demonstrates early ART attrition among Option B+ patients and contributes evidence on the characteristics of women who are most at risk of attrition in Haiti. Our findings highlight the importance of targeted strategies to support retention among Option B+ patients.

From 2012 HAITI-SIS Survey: thick-skin versus thin-skin tectonics partitioned along offshore strike-slip Faults-Haïti

NASA Astrophysics Data System (ADS)

Ellouz, N.; Leroy, S. D.; Momplaisir, R.; Mercier de Lepinay, B.

2013-12-01

The characterization of the deformation along large strike-slip fault-systems like transpressive boundaries between N. Caribbean/N America is a challenging topic, which requires a multi-scale approach. Thanks to Haiti-sis new data, the precise description of the fault segmentation pattern, the sedimentogical distribution, the uplift/subsidence rates, the along-fault and intra-basin fluids circulations, allows to actualize the evolution of the deformation history up to present-day . All the co-seismic surface to near-surface events, have to be also identified in order to integrate geophysical solutions for the earthquake, within the present-day geological and structural pattern. These two approaches, ranging from geological to instantaneous time-scales have been used during multi-tools Haiti-Sis oceanographic survey, allowing to document and image these different aspects at a large scale. The complex strike-slip North Caribbean boundary registered significative stress partitioning. Oblique convergence is expressed by along-strike evolution; from rifted segments (Cayman Through) to transpressive ones (Haiti, Dominican Rep.), to subduction (Porto Rico). In the Haiti-Sis survey, we acquired new offshore data surrounding the active fault areas, in the Gonâve Bay, the Jamaica Channel and along Southern Peninsula. Mapping the sea-floor, and HR seismic acquisition were our main objectives, in order to characterize the fault and fold architecture, with a new delineation of active segments. Offshore piston cores, have been used as representative of the modern basin sedimentation, and to document the catastrophic events (earthquakes, massive flood or sudden destabilization of the platform ) represented by turbiditic or mass-flow sequences, with the objective to track the time recurrence of seismic events by dating some of these catastrophic sediment deposition. At surface, the other markers of the fault activity are linked with along-fault permeability and fluid circulation

"The women, they maltreat them… therefore, we cannot assure that the future society will be good": Male perspectives on gender-based violence: A focus group study with young men in Haiti.

PubMed

Gabriel, Naïka C; Sloand, Elizabeth; Gary, Faye; Hassan, Mona; Bertrand, Desiree R; Campbell, Jacquelyn

2016-07-01

The purpose of this study was to explore the perceptions of violence against women (VAW) held by Haitian men to gain a better understanding of why VAW occurs. Women in Haiti have experienced significant violence, both before and following the 2010 earthquake. Fifteen men aged 26 to 47 participated in a focus group. The data revealed three themes: men's beliefs about VAW and its context, factors influencing VAW, and recommended interventions. When approaching VAW, men must be part of the collective effort. Their insights are valuable when planning and implementing interventions to decrease VAW in Haiti and worldwide.

[Street children and AIDS in Haiti].

PubMed

Bernier, M; Ascensio, P

1995-01-01

This study is a qualitative inquiry KAP about sexuality, and adoption and preservation of safe sexual behaviors, among the children of the street in Port-au-Prince, Haiti. Three groups of participating children of the street were observed in Port-au-Prince for three months, during June through August 1991. The information was collected with the use of pre-tested charts for each theme chosen. Then, individual interviews were conducted with leaders identified among the educators and children of the street. One of the main goals of Aids educational programs of street children should be to make them believe in the existence of the disease, and the real risk it poses for death. The strategies that we will use to convince them should deal with the different social, psychological, economical, and environmental factors that characterized the children as follows: 1) their adherence to a peer group and the relationship of power between the older and younger children; 2) the fundamental importance of money in their life, and that all relationships that they have are based on the capacity of people to give them something, such as money; 3) the role of their social appearance and their need to behave like other children for even one day; 4) their low self-esteem; 5) their feeling of powerlessness and resignation related to their living conditions; 6) the influence of the street culture; and 7) their understanding of sexuality as an immediate pleasure.(ABSTRACT TRUNCATED AT 250 WORDS)

Epidemiology of Cyclospora cayetanensis and other intestinal parasites in a community in Haiti.

PubMed

Lopez, Adriana S; Bendik, Jean M; Alliance, Jean Y; Roberts, Jacquelin M; da Silva, Alexandre J; Moura, Iaci N S; Arrowood, Michael J; Eberhard, Mark L; Herwaldt, Barbara L

2003-05-01

We conducted an exploratory investigation in a community in Haiti to determine the prevalence of Cyclospora cayetanensis infection and to identify potential risk factors for C. cayetanensis infection. In 2001, two cross-sectional stool surveys and a nested case-control study were conducted. In 2002, a follow-up cross-sectional stool survey was conducted among children < or =10 years of age. Stool specimens from study participants and water samples from their wells were examined for Cyclospora and other intestinal parasites. In stools, the prevalence of infection with Cyclospora in persons of all ages decreased from 12% (20 of 167 persons) in February 2001 to 1.1% (4 of 352 persons) in April 2001, a 90.8% decrease. For children < or =10 years of age, the prevalence rates were 22.5% (16 of 71 children) in February 2001, 3.0% (4 of 135 children) in April 2001, and 2.5% (2 of 81 children) in January 2002. Use of the water from the artesian well in the northern region of the community versus the one in the south was the only risk factor associated with Cyclospora infection in multivariate analyses (odds ratio, 18.5; 95% confidence interval, 2.4 to 143.1). The water sample from one of the nine wells or water sources tested (one sample per source) in January 2001, shortly before the investigation began, was positive for Cyclospora by UV fluorescence microscopy and PCR. None of the water samples from the 46 wells or water sources tested during the investigation (one sample per source per testing period, including the artesian wells) were positive for Cyclospora. Further studies are needed to assess the role of water as a possible risk factor for Cyclospora infection in Haiti and other developing countries.

Limited Service Availability, Readiness, and Use of Facility-Based Delivery Care in Haiti: A Study Linking Health Facility Data and Population Data

PubMed Central

Wang, Wenjuan; Winner, Michelle; Burgert-Brucker, Clara R

2017-01-01

Background: Understanding the barriers that women in Haiti face to giving birth at a health facility is important for improving coverage of facility delivery and reducing persistently high maternal mortality. We linked health facility survey data and population survey data to assess the role of the obstetric service environment in affecting women's use of facility delivery care. Methods: Data came from the 2012 Haiti Demographic and Health Survey (DHS) and the 2013 Haiti Service Provision Assessment (SPA) survey. DHS clusters and SPA facilities were linked with their geographic coordinate information. The final analysis sample from the DHS comprised 4,921 women who had a live birth in the 5 years preceding the survey. Service availability was measured with the number of facilities providing delivery services within a specified distance from the cluster (within 5 kilometers for urban areas and 10 kilometers for rural areas). We measured facility readiness to provide obstetric care using 37 indicators defined by the World Health Organization. Random-intercept logistic regressions were used to model the variation in individual use of facility-based delivery care and cluster-level service availability and readiness, adjusting for other factors. Results: Overall, 39% of women delivered their most recent birth at a health facility and 61% delivered at home, with disparities by residence (about 60% delivered at a health facility in urban areas vs. 24% in rural areas). About one-fifth (18%) of women in rural areas and one-tenth (12%) of women in nonmetropolitan urban areas lived in clusters where no facility offered delivery care within the specified distances, while nearly all women (99%) in the metropolitan area lived in clusters that had at least 2 such facilities. Urban clusters had better service readiness compared with rural clusters, with a wide range of variation in both areas. Regression models indicated that in both rural and nonmetropolitan urban areas

Stratigraphy and sedimentology of the K/T boundary deposit in Haiti

NASA Technical Reports Server (NTRS)

Carey, S.; Sigurdsson, H.; Dhondt, S.; Espindola, J. M.

1993-01-01

The K/T boundary sequence is exposed in uplifted carbonate sediments of the southwest peninsula of Haiti. It is found at 15 localities within the Beloc formation, a sequence of limestone and marls interpreted as a monoclinal nappe structure thrust to the north. This tectonic deformation has affected the K/T boundary deposit to varying degrees. In some cases the less competent K/T deposit has acted as a slip plane leading to extensive shearing of the boundary layer, as well as duplication of the section. The presence of glassy tektites, shocked quartz, and an Ir anomaly directly link the deposit to a bolide impact. Stratigraphic and sedimentological features of the tripartite sequence indicate that it was formed by deposition from ballistic fallout of coarse tektites, emplacement of particle gravity flows and fine grained fallout of widely dispersed impact ejecta.

Crustal structure and fault geometry of the 2010 Haiti earthquake from temporary seismometer deployments

USGS Publications Warehouse

Douilly, Roby; Haase, Jennifer S.; Ellsworth, William L.; Bouin, Marie‐Paule; Calais, Eric; Symithe, Steeve J.; Armbruster, John G.; Mercier de Lépinay, Bernard; Deschamps, Anne; Mildor, Saint‐Louis; Meremonte, Mark E.; Hough, Susan E.

2013-01-01

Haiti has been the locus of a number of large and damaging historical earthquakes. The recent 12 January 2010 Mw 7.0 earthquake affected cities that were largely unprepared, which resulted in tremendous losses. It was initially assumed that the earthquake ruptured the Enriquillo Plantain Garden fault (EPGF), a major active structure in southern Haiti, known from geodetic measurements and its geomorphic expression to be capable of producing M 7 or larger earthquakes. Global Positioning Systems (GPS) and Interferometric Synthetic Aperture Radar (InSAR) data, however, showed that the event ruptured a previously unmapped fault, the Léogâne fault, a north‐dipping oblique transpressional fault located immediately north of the EPGF. Following the earthquake, several groups installed temporary seismic stations to record aftershocks, including ocean‐bottom seismometers on either side of the EPGF. We use data from the complete set of stations deployed after the event, on land and offshore, to relocate all aftershocks from 10 February to 24 June 2010, determine a 1D regional crustal velocity model, and calculate focal mechanisms. The aftershock locations from the combined dataset clearly delineate the Léogâne fault, with a geometry close to that inferred from geodetic data. Its strike and dip closely agree with the global centroid moment tensor solution of the mainshock but with a steeper dip than inferred from previous finite fault inversions. The aftershocks also delineate a structure with shallower southward dip offshore and to the west of the rupture zone, which could indicate triggered seismicity on the offshore Trois Baies reverse fault. We use first‐motion focal mechanisms to clarify the relationship of the fault geometry to the triggered aftershocks.

Predicting the evolution of large cholera outbreaks: lessons learnt from the Haiti case study

NASA Astrophysics Data System (ADS)

Bertuzzo, Enrico; Mari, Lorenzo; Righetto, Lorenzo; Knox, Allyn; Finger, Flavio; Casagrandi, Renato; Gatto, Marino; Rodriguez-Iturbe, Ignacio; Rinaldo, Andrea

2013-04-01

Mathematical models can provide key insights into the course of an ongoing epidemic, potentially aiding real-time emergency management in allocating health care resources and possibly anticipating the impact of alternative interventions. Spatially explicit models of waterborne disease are made routinely possible by widespread data mapping of hydrology, road network, population distribution, and sanitation. Here, we study the ex-post reliability of predictions of the ongoing Haiti cholera outbreak. Our model consists of a set of dynamical equations (SIR-like, i.e. subdivided into the compartments of Susceptible, Infected and Recovered individuals) describing a connected network of human communities where the infection results from the exposure to excess concentrations of pathogens in the water, which are, in turn, driven by hydrologic transport through waterways and by mobility of susceptible and infected individuals. Following the evidence of a clear correlation between rainfall events and cholera resurgence, we test a new mechanism explicitly accounting for rainfall as a driver of enhanced disease transmission by washout of open-air defecation sites or cesspool overflows. A general model for Haitian epidemic cholera and the related uncertainty is thus proposed and applied to the dataset of reported cases now available. The model allows us to draw predictions on longer-term epidemic cholera in Haiti from multi-season Monte Carlo runs, carried out up to January 2014 by using a multivariate Poisson rainfall generator, with parameters varying in space and time. Lessons learned and open issues are discussed and placed in perspective. We conclude that, despite differences in methods that can be tested through model-guided field validation, mathematical modeling of large-scale outbreaks emerges as an essential component of future cholera epidemic control.

Household and Individual Risk Factors for Cholera among Cholera Vaccine Recipients in Rural Haiti.

PubMed

Matias, Wilfredo R; Teng, Jessica E; Hilaire, Isabelle J; Harris, Jason B; Franke, Molly F; Ivers, Louise C

2017-08-01

Oral cholera vaccination was used as part of cholera control in Haiti, but the vaccine does not provide complete protection. We conducted secondary data analyses of a vaccine effectiveness study in Haiti to evaluate risk factors for cholera among cholera vaccine recipients. Individuals vaccinated against cholera that presented with acute watery diarrhea and had a stool sample positive for Vibrio cholerae O1 were included as cases. Up to four vaccinated individuals who did not present for treatment of diarrhea were included as controls for each case, and matched by location of residence, enrollment time, and age. We evaluated sociodemographic characteristics and risk factors for cholera. Univariable and multivariable logistic regression were performed to identify risk factors for cholera among vaccinees. Thirty-three vaccine recipients with culture-confirmed cholera were included as cases. One-hundred-and-seventeen of their matched controls reported receiving vaccine and were included as controls. In a multivariable analysis, self-reporting use of branded household water disinfection products as a means of treating water (adjusted relative risk [aRR] = 44.3, 95% confidence interval [CI] = 4.19-468.05, P = 0.002), and reporting having a latrine as the main household toilet (aRR = 4.22, 95% CI = 1.23-14.43, P = 0.02), were independent risk factors for cholera. Self-reporting always treating water (aRR = 0.09, 95% CI = 0.01-0.57, P = 0.01) was associated with protection against cholera. The field effectiveness of water, sanitation, and hygiene interventions used in combination with cholera vaccination in cholera control should be measured and monitored over time to identify and remediate shortcomings, and ensure successful impact on disease control.

An organized, comprehensive, and security-enabled strategic response to the Haiti earthquake: a description of pre-deployment readiness preparation and preliminary experience from an academic anesthesiology department with no preexisting international disaster response program.

PubMed

McCunn, Maureen; Ashburn, Michael A; Floyd, Thomas F; Schwab, C William; Harrington, Paul; Hanson, C William; Sarani, Babak; Mehta, Samir; Speck, Rebecca M; Fleisher, Lee A

2010-12-01

On Tuesday, January 12, 2010 at 16:53 local time, a magnitude 7.0 M(w) earthquake struck Haiti. The global humanitarian attempt to respond was swift, but poor infrastructure and emergency preparedness limited many efforts. Rapid, successful deployment of emergency medical care teams was accomplished by organizations with experience in mass disaster casualty response. Well-intentioned, but unprepared, medical teams also responded. In this report, we describe the preparation and planning process used at an academic university department of anesthesiology with no preexisting international disaster response program, after a call from an American-based nongovernmental organization operating in Haiti requested medical support. The focus of this article is the pre-deployment readiness process, and is not a post-deployment report describing the medical care provided in Haiti. A real-time qualitative assessment and systematic review of the Hospital of the University of Pennsylvania's communications and actions relevant to the Haiti earthquake were performed. Team meetings, conference calls, and electronic mail communication pertaining to planning, decision support, equipment procurement, and actions and steps up to the day of deployment were reviewed and abstracted. Timing of key events was compiled and a response timeline for this process was developed. Interviews with returning anesthesiology members were conducted. Four days after the Haiti earthquake, Partners in Health, a nonprofit, nongovernmental organization based in Boston, Massachusetts, with >20 years of experience providing medical care in Haiti contacted the University of Pennsylvania Health System to request medical team support. The departments of anesthesiology, surgery, orthopedics, and nursing responded to this request with a volunteer selection process, vaccination program, and systematic development of equipment lists. World Health Organization and Centers for Disease Control guidelines, the American

USGS remote sensing coordination for the 2010 Haiti earthquake

USGS Publications Warehouse

Duda, Kenneth A.; Jones, Brenda

2011-01-01

In response to the devastating 12 January 2010, earthquake in Haiti, the US Geological Survey (USGS) provided essential coordinating services for remote sensing activities. Communication was rapidly established between the widely distributed response teams and data providers to define imaging requirements and sensor tasking opportunities. Data acquired from a variety of sources were received and archived by the USGS, and these products were subsequently distributed using the Hazards Data Distribution System (HDDS) and other mechanisms. Within six weeks after the earthquake, over 600,000 files representing 54 terabytes of data were provided to the response community. The USGS directly supported a wide variety of groups in their use of these data to characterize post-earthquake conditions and to make comparisons with pre-event imagery. The rapid and continuing response achieved was enabled by existing imaging and ground systems, and skilled personnel adept in all aspects of satellite data acquisition, processing, distribution and analysis. The information derived from image interpretation assisted senior planners and on-site teams to direct assistance where it was most needed.

Sexual risk behaviors among adolescents in Port-au-Prince, Haiti.

PubMed

Carver, Jasmine W; Dévieux, Jessy G; Gaston, Stéphanie C; Altice, Frederick L; Niccolai, Linda M

2014-08-01

Engagement in sexual activity among Haitian youth is increasing. The present cross-sectional study examined the independent correlates of sexual risk behaviors among 200 (108 male/92 female) 13-18 year-old adolescents in Port-au-Prince, Haiti using face-to-face interviews. The majority (60.0 %) had engaged in sexual intercourse. Multivariate modeling found males to be 3.52 times more likely to have had sex, 5.42 times more likely to report sexual debut before age 14, 9.75 times more likely to have >1 sexual partner, and 3.33 times more likely to not have used a condom during last sex. Adolescents living with parents, grandparents, aunts or uncles were less likely to report having unprotected sex compared with those without adult family members in the home (AOR range 0.26-0.51). The high prevalence of risky sex among males and the protective influence of stable family cohesiveness have important implications for HIV prevention efforts.

Mobile clinics in Haiti, part 1: Preparing for service-learning.

PubMed

Cone, Pamela H; Haley, Janice M

2016-11-01

Mobile clinics have been used successfully to provide healthcare services to people in hard to reach areas around the world, but their use is sometimes controversial. There are advantages to using mobile clinics among rural underserved populations, and providing access to those who are vulnerable will improve health and decrease morbidity and mortality. However, some teams use inappropriate approaches to international service. For over 15 years, Azusa Pacific University School of Nursing has sponsored mobile clinics to rural northern Haiti with the aim to provide culturally sensitive healthcare in collaboration with Haitian leaders. Experience and exploring the literature have informed the APU-SoN approach on best practices for planning and preparing study abroad, service-learning trips that provide healthcare services. The authors hope that this description of the preparation and planning needed for appropriate and culturally sensitive service-learning experiences abroad will benefit others who seek to provide healthcare study abroad opportunities around the world. Copyright © 2016 Elsevier Ltd. All rights reserved.

“The Women, They Maltreat Them…Therefore, We Cannot Assure That the Future Society Will Be Good”: Male Perspectives on Gender-Based Violence: A Focus Group Study With Young Men in Haiti

PubMed Central

Gabrie, Naïka C.; Sloand, Elizabeth; Gary, Faye; Hassan, Mona; Bertrand, Desiree R.; Campbell, Jacquelyn

2016-01-01

The purpose of this study was to explore the perceptions of violence against women (VAW) held by Haitian men to gain a better understanding of why VAW occurs. Women in Haiti have experienced significant violence, both before and following the 2010 earthquake. Fifteen men ages 26 to 47 participated in a focus group. The data revealed three themes: men's beliefs about VAW and its context, factors influencing VAW, and recommended interventions. When approaching VAW, men must be part of the collective effort. Their insights are valuable when planning and implementing interventions to decrease VAW in Haiti and worldwide. PMID:26361648

Shooting Back and "Looking for Life" in the USA and Haiti: "Seeing" the Ethics of Visual Research Methods through a Development Lens

ERIC Educational Resources Information Center

Zenkov, Kristien; Ewaida, Marriam; Lynch, Megan R.; Bell, Athene; Harmon, James; Pellegrino, Anthony; Sell, Corey

2014-01-01

Relying on a critical pedagogy framework and youth participatory action research (YPAR) and visual sociology methods, the authors of this article--teachers, teacher educators, and community activists--have worked with photo elicitation methods and young adults in the USA and Haiti to document youths' impressions of the purposes of, supports for,…

Human rights assessment in Parc Jean Marie Vincent, Port-au-Prince, Haiti.

PubMed

Cullen, Kimberly A; Ivers, Louise C

2010-12-15

Months after a 7.0 magnitude earthquake hit Port-au-Prince, Haiti, over one million remain homeless and living in spontaneous internally displaced person (IDP) camps. Billions of dollars from aid organizations and government agencies have been pledged toward the relief effort, yet many basic human needs, including food, shelter, and sanitation, continue to be unmet. The Sphere Project, "Humanitarian Charter and Minimum Standards in Disaster Response," identifies the minimum standards to be attained in disaster response. From a human rights perspective and utilizing key indicators from the Sphere Project as benchmarks, this article reports on an assessment of the living conditions approximately 12 weeks after the earthquake in Parc Jean Marie Vincent, a spontaneous IDP camp in Port-au-Prince. A stratified random sample of households in the camp, proportionate to the number of families living in each sector, was selected. Interview questions were designed to serve as "key indicators" for the Sphere Project minimum standards. A total of 486 interviews were completed, representing approximately 5% of households in each of the five sectors of the camp. Our assessment identified the relative achievements and shortcomings in the provision of relief services in Parc Jean Marie Vincent. At the time of this survey, the Sphere Project minimum standards for access to health care and quantity of water per person per day were being met. Food, shelter, sanitation, and security were below minimum accepted standard and of major concern. The formal assessment reported here was completed by September 2010, and is necessarily limited to conditions in Haiti before the cholera outbreak in October. Copyright © 2010 Cullen and Ivers. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any

[What is important in disaster relief missions associated with the Great East Japan Earthquake: lessons from disaster relief missions to the Japan Self-Defense Forces Sendai Hospital and Haiti peacekeeping deployments].

PubMed

Tanichi, Masaaki; Tatsuki, Toshitaka; Saito, Taku; Wakizono, Tomoki; Shigemura, Jun

2012-01-01

We assessed the core factors necessary for mental health of disaster workers according to the following experiences: 1) the Japan Self-Defense Force (JSDF) disaster relief missions associated with the Great East Japan Earthquake and the Haiti peacekeeping deployment associated with the Great Haiti Earthquake, 2) conformations of the peacekeeping mission units of various countries deployed to Haiti, and 3) JSDF assistance activities to the Japanese earthquake victims. We learned that the basic life needs were the major premises for maintaining the mental health of the disaster workers. Food, drinking supplies, medical supplies were particularly crucial, yet overlooked in Japanese worker settings compared with forces of other countries. Conversely, the workers tend to feel guilty (moushi wake nai) for the victims when their basic life infrastructures are better than those of the victims. The Japanese workers and disaster victims both tend to find comfort in styles based on their culture, in particular, open-air baths and music performances. When planning workers' environments in disaster settings, provision of basic infrastructure should be prioritized, yet a sense of balance based on cultural background may be useful to enhance the workers' comfort and minimize their guilt.

Using ArcMap, Google Earth, and Global Positioning Systems to select and locate random households in rural Haiti.

PubMed

Wampler, Peter J; Rediske, Richard R; Molla, Azizur R

2013-01-18

A remote sensing technique was developed which combines a Geographic Information System (GIS); Google Earth, and Microsoft Excel to identify home locations for a random sample of households in rural Haiti. The method was used to select homes for ethnographic and water quality research in a region of rural Haiti located within 9 km of a local hospital and source of health education in Deschapelles, Haiti. The technique does not require access to governmental records or ground based surveys to collect household location data and can be performed in a rapid, cost-effective manner. The random selection of households and the location of these households during field surveys were accomplished using GIS, Google Earth, Microsoft Excel, and handheld Garmin GPSmap 76CSx GPS units. Homes were identified and mapped in Google Earth, exported to ArcMap 10.0, and a random list of homes was generated using Microsoft Excel which was then loaded onto handheld GPS units for field location. The development and use of a remote sensing method was essential to the selection and location of random households. A total of 537 homes initially were mapped and a randomized subset of 96 was identified as potential survey locations. Over 96% of the homes mapped using Google Earth imagery were correctly identified as occupied dwellings. Only 3.6% of the occupants of mapped homes visited declined to be interviewed. 16.4% of the homes visited were not occupied at the time of the visit due to work away from the home or market days. A total of 55 households were located using this method during the 10 days of fieldwork in May and June of 2012. The method used to generate and field locate random homes for surveys and water sampling was an effective means of selecting random households in a rural environment lacking geolocation infrastructure. The success rate for locating households using a handheld GPS was excellent and only rarely was local knowledge required to identify and locate households. This

Simulation of broad-band strong ground motion for a hypothetical Mw 7.1 earthquake on the Enriquillo Fault in Haiti

NASA Astrophysics Data System (ADS)

Douilly, Roby; Mavroeidis, George P.; Calais, Eric

2017-10-01

The devastating 2010 Mw 7.0 Haiti earthquake demonstrated the need to improve mitigation and preparedness for future seismic events in the region. Previous studies have shown that the earthquake did not occur on the Enriquillo Fault, the main plate boundary fault running through the heavily populated Port-au-Prince region, but on the nearby and previously unknown transpressional Léogâne Fault. Slip on that fault has increased stresses on the segment of Enriquillo Fault to the east of Léogâne, which terminates in the ˜3-million-inhabitant capital city of Port-au-Prince. In this study, we investigate ground shaking in the vicinity of Port-au-Prince, if a hypothetical rupture similar to the 2010 Haiti earthquake occurred on that segment of the Enriquillo Fault. We use a finite element method and assumptions on regional tectonic stress to simulate the low-frequency ground motion components using dynamic rupture propagation for a 52-km-long segment. We consider eight scenarios by varying parameters such as hypocentre location, initial shear stress and fault dip. The high-frequency ground motion components are simulated using the specific barrier model in the context of the stochastic modeling approach. The broad-band ground motion synthetics are subsequently obtained by combining the low-frequency components from the dynamic rupture simulation with the high-frequency components from the stochastic simulation using matched filtering at a crossover frequency of 1 Hz. Results show that rupture on a vertical Enriquillo Fault generates larger horizontal permanent displacements in Léogâne and Port-au-Prince than rupture on a south-dipping Enriquillo Fault. The mean horizontal peak ground acceleration (PGA), computed at several sites of interest throughout Port-au-Prince, has a value of ˜0.45 g, whereas the maximum horizontal PGA in Port-au-Prince is ˜0.60 g. Even though we only consider a limited number of rupture scenarios, our results suggest more intense ground

Tsunamis triggered by the 12 January 2010 Earthquake in Haiti

NASA Astrophysics Data System (ADS)

Fritz, H. M.; Hillaire, J. V.; Molière, E.; Mohammed, F.; Wei, Y.

2010-12-01

On 12 January 2010 a magnitude Mw 7.0 earthquake occurred 25 km west-southwest of Haiti’s Capital of Port-au-Prince, which resulted in more than 230,000 fatalities. In addition tsunami waves triggered by the earthquake caused at least 3 fatalities at Petit Paradis. Unfortunately, the people of Haiti had neither ancestral knowledge nor educational awareness of tsunami hazards despite the 1946 Dominican Republic tsunami at Hispaniola’s northeast coast. In sharp contrast Sri Lankan UN-soldiers on duty at Jacmel self-evacuated given the memory of the 2004 Indian Ocean tsunami. The International Tsunami Survey Team (ITST) documented flow depths, runup heights, inundation distances, sediment deposition, damage patterns at various scales, and performance of the man-made infrastructure and impact on the natural environment. The 31 January to 7 February 2010 ITST covered the greater Bay of Port-au-Prince and more than 100 km of Hispaniola’s south coast between Pedernales, Dominican Republic and Jacmel, Haiti. The Hispaniola survey data includes more than 20 runup and flow depth measurements. The tsunami impacts peaked with maximum flow depths exceeding 3 m both at Petit Paradis inside the Bay of Grand Goâve located 45 km west-southwest of Port-au-Prince and at Jacmel on Haiti’s south coast. A significant variation in tsunami impact was observed on Hispaniola and tsunami runup of more than 1 m was still observed at Pedernales in the Dominican Republic. Jacmel, which is near the center of the south coast, represents an unfortunate example of a village and harbor that was located for protection from storm waves but is vulnerable to tsunami waves with runup doubling from the entrance to the head of the bay. Inundation and damage was limited to less than 100 m inland at both Jacmel and Petit Paradis. Differences in wave period were documented between the tsunami waves at Petit Paradis and Jacmel. The Petit Paradis tsunami is attributed to a coastal submarine landslide

Introducing cholera vaccination in Asia, Africa and Haiti: a meeting report.

PubMed

Hall, Robert H; Sack, David A

2015-01-15

Orally-administered cholera vaccine (OCV) has been increasingly examined as an additional tool to intervene against endemic and epidemic cholera. In 2013, short- and long-term field experience with OCV under nine distinctive field settings was reported from India, Bangladesh, Vietnam, Guinea, Haiti, and Thailand. Lead investigators from each of these projects presented their findings at a symposium chaired by Drs. David A. Sack and Robert H. Hall at the Vaccines for Enteric Diseases (VED) Conference in Bangkok on November 7, 2013. The objective of the symposium was to describe the unique features of each setting and project, share field experience of implementing cholera vaccination, discuss results, and identify constraints to the wider use of OCV. The VED provided a forum where >200 attendees engaged with this exciting and potentially decisive new development in the cholera field. Copyright © 2014. Published by Elsevier Ltd.. All rights reserved.

Seismic Hazard in Haiti: A Geologic Perspective

NASA Astrophysics Data System (ADS)

Prentice, C. S.; Crone, A. J.; Gold, R. D.; Briggs, R. W.; Narcisse, R.

2012-12-01

The catastrophic M 7.0 earthquake that occurred in Haiti on 12 January 2010 highlighted the hazard associated with the Caribbean-North American plate boundary in Hispaniola. Detailed analysis and modeling of geologic, geodetic, and seismologic data showed that most of the moment release occurred on a previously unidentified, north-dipping, blind thrust fault (now named the Léogâne fault), which is north of the plate-bounding, left-lateral Enriquillo-Plantain Garden fault (EPGF). The result that the Léogâne fault was the source of the 2010 earthquake implies that the EPGF remains a significant hazard and raises the question of other potential seismic sources near Port-au-Prince (PaP). Following the earthquake, we mapped Quaternary traces of the EPGF in the field using satellite imagery, aerial photography, and LiDAR data. We identified three paleoseismic study sites along the EPGF: the Jean-Jean and Marianne sites southwest of PaP along the Momance section of the EPGF and the Riviére Grise site southeast of PaP along the Dumay section. Trenches at the Jean-Jean site show fault strands breaking nearly to the ground surface, but that did not move in the 2010 earthquake. We collected radiocarbon samples from faulted strata that we anticipate will provide constraints on the age of the most recent surface rupture. We also identified a buried channel deposit that is left-laterally offset a minimum of 3 m, and collected radiocarbon samples to constrain its age. In a natural stream cut at the Marianne site, we documented three colluvial wedges, and collected samples for optically stimulated luminescence (OSL) dating that we anticipate will provide age constraints on the three most recent earthquakes. At Riviére Grise we documented evidence for three surface ruptures in a fluvial terrace deposit, and collected OSL samples to constrain their ages. Our preliminary geomorphic analysis of a belt of low hills north of the EPGF and east of PaP suggests that these hills are

Household and Individual Risk Factors for Cholera among Cholera Vaccine Recipients in Rural Haiti

PubMed Central

Matias, Wilfredo R.; Teng, Jessica E.; Hilaire, Isabelle J.; Harris, Jason B.; Franke, Molly F.; Ivers, Louise C.

2017-01-01

Abstract. Oral cholera vaccination was used as part of cholera control in Haiti, but the vaccine does not provide complete protection. We conducted secondary data analyses of a vaccine effectiveness study in Haiti to evaluate risk factors for cholera among cholera vaccine recipients. Individuals vaccinated against cholera that presented with acute watery diarrhea and had a stool sample positive for Vibrio cholerae O1 were included as cases. Up to four vaccinated individuals who did not present for treatment of diarrhea were included as controls for each case, and matched by location of residence, enrollment time, and age. We evaluated sociodemographic characteristics and risk factors for cholera. Univariable and multivariable logistic regression were performed to identify risk factors for cholera among vaccinees. Thirty-three vaccine recipients with culture-confirmed cholera were included as cases. One-hundred-and-seventeen of their matched controls reported receiving vaccine and were included as controls. In a multivariable analysis, self-reporting use of branded household water disinfection products as a means of treating water (adjusted relative risk [aRR] = 44.3, 95% confidence interval [CI] = 4.19–468.05, P = 0.002), and reporting having a latrine as the main household toilet (aRR = 4.22, 95% CI = 1.23–14.43, P = 0.02), were independent risk factors for cholera. Self-reporting always treating water (aRR = 0.09, 95% CI = 0.01–0.57, P = 0.01) was associated with protection against cholera. The field effectiveness of water, sanitation, and hygiene interventions used in combination with cholera vaccination in cholera control should be measured and monitored over time to identify and remediate shortcomings, and ensure successful impact on disease control. PMID:28722575

Counseling and Knowledge of Danger Signs of Pregnancy Complications in Haiti, Malawi, and Senegal.

PubMed

Assaf, Shireen

2018-06-23

Objectives Providing counseling on danger signs of pregnancy complications as part of visits for antenatal care (ANC) can raise expecting women's awareness so that if danger signs occur they can seek assistance in time. The study examines the level of agreement in counseling on danger signs between observation of the provider during the ANC visit and the client's report in the exit interview, and the association of this agreement with the client's level of knowledge on danger signs. Methods The analysis used data from service provision and assessment (SPA) surveys in Haiti, Malawi, and Senegal. Agreement between the observation and client's report was measured by Cohen's kappa and percent agreement. Regressions were performed on the number of danger signs the client knew, with the level of agreement on the counseling on danger signs as the main independent variable. Results The study found little agreement between the observation of counseling and the client's report that the counseling occurred, despite the fact that the exit interview with the client was performed immediately following the ANC visit with the provider. The level of positive agreement between observation and client's report was 17% in Haiti, 33% in Malawi, and 23% in Senegal. Clients' overall knowledge of danger signs was low; in all three countries the mean number of danger signs known was 1.5 or less. The regression analysis found that, in order to show a significant increase in knowledge of danger signs, it was important for the client to report that it took place. Conclusions Ideally, there should be 100% positive agreement that counseling occurred. To achieve this level requires raising both the level of counseling on danger signs of pregnancy complications and its quality. While challenges exist, providing counseling that is more client-centered and focuses on the client's needs could improve quality and thus could increase the client's knowledge of danger signs.

Networks in disasters: Multidisciplinary communication and coordination in response and recovery to the 2010 Haiti Earthquake (Invited)

NASA Astrophysics Data System (ADS)

McAdoo, B. G.; Augenstein, J.; Comfort, L.; Huggins, L.; Krenitsky, N.; Scheinert, S.; Serrant, T.; Siciliano, M.; Stebbins, S.; Sweeney, P.; University Of Pittsburgh Haiti Reconnaissance Team

2010-12-01

The 12 January 2010 earthquake in Haiti demonstrates the necessity of understanding information communication between disciplines during disasters. Armed with data from a variety of sources, from geophysics to construction, water and sanitation to education, decision makers can initiate well-informed policies to reduce the risk from future hazards. At the core of this disaster was a natural hazard that occurred in an environmentally compromised country. The earthquake itself was not solely responsible for the magnitude of the disaster- poor construction practices precipitated by extreme poverty, a two centuries of post-colonial environmental degradation and a history of dysfunctional government shoulder much of the responsibility. Future policies must take into account the geophysical reality that future hazards are inevitable and may occur within the very near future, and how various institutions will respond to the stressors. As the global community comes together in reconstruction efforts, it is necessary for the various actors to take into account what vulnerabilities were exposed by the earthquake, most vividly seen during the initial response to the disaster. Responders are forced to prioritize resources designated for building collapse and infrastructure damage, delivery of critical services such as emergency medical care, and delivery of food and water to those in need. Past disasters have shown that communication lapses between the response and recovery phases results in many of the exposed vulnerabilities not being adequately addressed, and the recovery hence fails to bolster compromised systems. The response reflects the basic characteristics of a Complex Adaptive System, where new agents emerge and priorities within existing organizations shift to deal with new information. To better understand how information is shared between actors during this critical transition, we are documenting how information is communicated between critical sectors during the

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response.

PubMed

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-08-01

Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

Clinical Features of Human Immunodeficiency Virus–Infected Patients Presenting with Cholera in Port-au-Prince, Haiti

PubMed Central

Sévère, Karine; Anglade, Stravinsky B.; Bertil, Claudin; Duncan, Aynsley; Joseph, Patrice; Deroncenay, Alexandra; Mabou, Marie M.; Ocheretina, Oksana; Reif, Lindsey; Seo, Grace; Pape, Jean W.; Fitzgerald, Daniel W.

2016-01-01

Human immunodeficiency virus (HIV) infection has been postulated to alter the natural history of cholera, including increased susceptibility to infection, severity of illness, and chronic carriage of Vibrio cholerae. Haiti has a generalized HIV epidemic with an adult HIV prevalence of 1.9% and recently suffered a cholera epidemic. We conducted a prospective study at the cholera treatment center (CTC) of GHESKIO in Haiti to characterize the coinfection. Adults admitted at the CTC for acute diarrhea were invited to participate in the study. Vital signs, frequency, and volume of stools and/or vomiting were monitored, and single-dose doxycycline was administered. After counseling, participants were screened for HIV by enzyme-linked immunosorbent assay and for cholera by culture. Of 729 adults admitted to the CTC, 99 (13.6%) had HIV infection, and 457 (63%) had culture-confirmed cholera. HIV prevalence was three times higher in patients without cholera (23%, 63/272) than in those with culture-confirmed cholera (7.9%, 36/457). HIV prevalence in patients with culture-confirmed cholera (7.9%) was four times higher than the adult prevalence in Port-au-Prince (1.9%). Of the 36 HIV-infected patients with cholera, 25 (69%) had moderate/severe dehydration versus 302/421 (72%) in the HIV negative. Of 30 HIV-infected patients with weekly stool cultures performed after discharge, 29 (97%) were negative at week 1. Of 50 HIV-negative patients with weekly stool cultures, 49 (98%) were negative at week 1. In countries with endemic HIV infection, clinicians should consider screening patients presenting with suspected cholera for HIV coinfection. PMID:27549637

Assessment of Drinking Water Sold from Private Sector Kiosks in Post-Earthquake Port-au-Prince, Haiti.

PubMed

Patrick, Molly; Steenland, Maria; Dismer, Amber; Pierre-Louis, Jocelyne; Murphy, Jennifer L; Kahler, Amy; Mull, Bonnie; Etheart, Melissa D; Rossignol, Emmanuel; Boncy, Jacques; Hill, Vincent; Handzel, Thomas

2017-10-01

Consumption of drinking water from private vendors has increased considerably in Port-au-Prince, Haiti, in recent decades. A major type of vendor is private kiosks, advertising reverse osmosis-treated water for sale by volume. To describe the scale and geographical distribution of private kiosks in metropolitan Port-au-Prince, an inventory of private kiosks was conducted from July to August 2013. Coordinates of kiosks were recorded with global positioning system units and a brief questionnaire was administered with the operator to document key kiosk characteristics. To assess the quality of water originating from private kiosks, water quality analyses were also conducted on a sample of those inventoried as well as from the major provider company sites. The parameters tested were Escherichia coli , free chlorine residual, pH, turbidity, and total dissolved solids. More than 1,300 kiosks were inventoried, the majority of which were franchises of four large provider companies. Approximately half of kiosks reported opening within 12 months of the date of the inventory. The kiosk treatment chain and sales price was consistent among a majority of the kiosks. Of the 757 kiosks sampled for water quality, 90.9% of samples met World Health Organization (WHO) microbiological guideline at the point of sale for nondetectable E. coli in a 100-mL sample. Of the eight provider company sites tested, all samples met the WHO microbiological guideline. Because of the increasing role of the private sector in drinking water provision in Port-au-Prince and elsewhere in Haiti, this assessment was an important first step for government regulation of this sector.

Development and use of a master health facility list: Haiti's experience during the 2010 earthquake response

PubMed Central

Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa

2014-01-01

ABSTRACT Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system. PMID:25276595

Air quality in developing world disaster and conflict zones--the case of post-earthquake Haiti.

PubMed

Davis, Mary E; Rappaport, Ann

2014-10-15

Data on air quality are remarkably limited in the poorest of the world's countries. This is especially true for post-conflict and disaster zones, where international relief efforts focus largely on more salient public health challenges such as water and sanitation, infectious diseases, and housing. Using post-earthquake Haiti as the example case, this commentary explores air quality challenges in the developing world, highlighting concerns related to infrastructure damage from post-conflict and disaster settings. We contend that there is a growing and presently unmet need for further research and attention from the global health community to address these issues. Copyright © 2014 Elsevier B.V. All rights reserved.

Short report: documentation of iodine deficiency in Haitian schoolchildren: implication for lymphatic filariasis elimination in Haiti.

PubMed

Beach, M J; Streit, T G; Houston, R; May, W A; Addiss, D G; Lammie, P J

2001-01-01

In this study we documented unexpected moderate-to-severe iodine deficiency in Haitian schoolchildren although they live in a coastal community where presumably they have access to iodine-containing seafood. This fact combined with the lack of an iodized salt supply and endemic lymphatic filariasis makes community distribution of diethylcarbamazine-fortified, iodized salt an attractive strategy for elimination of lymphatic filariasis and iodine deficiency disorders in this area of Haiti. Combining lymphatic filariasis elimination with other public health interventions is one strategy to increase its public health benefit and maximize the impact of limited public health resources.

Satellite Map of Port-au-Prince, Haiti-2010-Infrared

USGS Publications Warehouse

Cole, Christopher J.; Sloan, Jeff

2010-01-01

The U.S. Geological Survey produced 1:24,000-scale post-earthquake image base maps incorporating high- and medium-resolution remotely sensed imagery following the 7.0 magnitude earthquake near the capital city of Port au Prince, Haiti, on January 12, 2010. Commercial 2.4-meter multispectral QuickBird imagery was acquired by DigitalGlobe on January 15, 2010, following the initial earthquake. Ten-meter multispectral ALOS AVNIR-2 imagery was collected by the Japanese Space Agency (JAXA) on January 12, 2010. These data were acquired under the Remote Sensing International Charter, a global team of space and satellite agencies that provide timely imagery in support of emergency response efforts worldwide. The images shown on this map were employed to support earthquake response efforts, specifically for use in determining ground deformation, damage assessment, and emergency management decisions. The raw, unprocessed imagery was geo-corrected, mosaicked, and reproduced onto a cartographic 1:24,000-scale base map. These maps are intended to provide a temporally current representation of post-earthquake ground conditions, which may be of use to decision makers and to the general public.

Water-resources reconnaissance of Isle de la Gonave, Haiti

USGS Publications Warehouse

Troester, J.W.; Turvey, M.D.

2004-01-01

Isle de la Gonave is a 750-km2 island off the coast of Haiti. The depth to the water table ranges from less than 30 m in the Eocene and Upper Miocene limestones to over 60 m in the 300-m-thick Quaternary limestone. Annual precipitation ranges from 800-1,400 mm. Most precipitation is lost through evapotranspiration and there is virtually no surface water. Roughly estimated from chloride mass balance, about 4% of the precipitation recharges the karst aquifer. Cave pools and springs are a common source for water. Hand-dug wells provide water in coastal areas. Few productive wells have been drilled deeper than 60 m. Reconnaissance field analyses indicate that groundwater in the interior is a calcium-bicarbonate type, whereas water at the coast is a sodium-chloride type that exceeds World Health Organization recommended values for sodium and chloride. Tests for the presence of hydrogen sulfide-producing bacteria were negative in most drilled wells, but positive in cave pools, hand-dug wells, and most springs, indicating bacterial contamination of most water sources. Because of the difficulties in obtaining freshwater, the 110,000 inhabitants use an average of only 7 L per person per day.

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

PubMed

Schackman, Bruce R; Neukermans, Christopher P; Fontain, Sandy N Nerette; Nolte, Claudine; Joseph, Patrice; Pape, Jean W; Fitzgerald, Daniel W

2007-05-01

New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries

Site characterization and site response in Port-au-Prince, Haiti

USGS Publications Warehouse

Hough, Susan E.; Yong, Alan K.; Altidor, Jean Robert; Anglade, Dieuseul; Given, Douglas D.; Mildor, Saint-Louis

2011-01-01

Waveform analysis of aftershocks of the Mw7.0 Haiti earthquake of 12 January 2010 reveals amplification of ground motions at sites within the Cul de Sac valley in which Port-au-Prince is situated. Relative to ground motions recorded at a hard-rock reference site, peak acceleration values are amplified by a factor of approximately 1.8 at sites on low-lying Mio-Pliocene deposits in central Port-au-Prince and by a factor of approximately 2.5–3 on a steep foothill ridge in the southern Port-au-Prince metropolitan region. The observed amplitude, predominant periods, variability, and polarization of amplification are consistent with predicted topographic amplification by a steep, narrow ridge. A swath of unusually high damage in this region corresponds with the extent of the ridge where high weak-motion amplifications are observed. We use ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) imagery to map local geomorphology, including characterization of both near-surface and of small-scale topographic structures that correspond to zones of inferred amplification.

Application of a paper based device containing a new culture medium to detect Vibrio cholerae in water samples collected in Haiti.

PubMed

Briquaire, Romain; Colwell, Rita R; Boncy, Jacques; Rossignol, Emmanuel; Dardy, Aline; Pandini, Isabelle; Villeval, François; Machuron, Jean-Louis; Huq, Anwar; Rashed, Shah; Vandevelde, Thierry; Rozand, Christine

2017-02-01

Cholera is now considered to be endemic in Haiti, often with increased incidence during rainy seasons. The challenge of cholera surveillance is exacerbated by the cost of sample collection and laboratory analysis. A diagnostic tool is needed that is low cost, easy-to-use, and able to detect and quantify Vibrio cholerae accurately in water samples within 18-24h, and perform reliably in remote settings lacking laboratory infrastructure and skilled staff. The two main objectives of this study were to develop and evaluate a new culture medium embedded in a new diagnostic tool (PAD for paper based analytical device) for detecting Vibrio cholerae from water samples collected in Haiti. The intent is to provide guidance for corrective action, such as chlorination, for water positive for V. cholerae epidemic strains. For detecting Vibrio cholerae, a new chromogenic medium was designed and evaluated as an alternative to thiosulfate citrate bile salts sucrose (TCBS) agar for testing raw water samples. Sensitivity and specificity of the medium were assessed using both raw and spiked water samples. The Vibrio cholerae chromogenic medium was proved to be highly selective against most of the cultivable bacteria in the water samples, without loss of sensitivity in detection of V. cholerae. Thus, reliability of this new culture medium for detection of V. cholerae in the presence of other Vibrio species in water samples offers a significant advantage. A new paper based device containing the new chromogenic medium previously evaluated was compared with reference methods for detecting V. cholerae from spiked water sample. The microbiological PAD specifications were evaluated in Haiti. More precisely, a total of 185 water samples were collected at five sites in Haiti, June 2014 and again in June 2015. With this new tool, three V. cholerae O1 and 17 V. cholerae non-O1/O139 strains were isolated. The presence of virulence-associated and regulatory genes, including ctxA, zot, ace, and tox

Isolation of an Enterovirus D68 from Blood from a Child with Pneumonia in Rural Haiti: Close Phylogenetic Linkage with New York Strain.

PubMed

ElBadry, Maha; Lednicky, John; Cella, Eleonora; Telisma, Taina; Chavannes, Sonese; Loeb, Julia; Ciccozzi, Massinno; Okech, Bernard; Beau De Rochars, Valery Madsen; Salemi, Marco; Morris, J Glenn

2016-09-01

We report the detection and isolation of enterovirus D68 from the blood of a 6-year-old child in rural Haiti, who presented with high fever and clinical signs suggestive of pneumonia. On phylogenetic analysis, this Haitian isolate was virtually identical to an enterovirus D68 strain circulating in New York during the same time period.

Strong ground motion in Port-au-Prince, Haiti, during the M7.0 12 January 2010 Haiti earthquake

USGS Publications Warehouse

Hough, Susan E; Given, Doug; Taniguchi, Tomoyo; Altidor, J.R.; Anglade, Dieuseul; Mildor, S-L.

2011-01-01

No strong motion records are available for the 12 January 2010 M7.0 Haiti earthquake. We use aftershock recordings as well as detailed considerations of damage to estimate the severity and distribution of mainshock shaking in Port-au-Prince. Relative to ground motions at a hard - rock reference site, peak accelerations are amplified by a factor of approximately 2 at sites on low-lying deposits in central Port-au-Prince and by a factor of 2.5 - 3.5 on a steep foothill ridge in the southern Port-au-Prince metropolitan region. The observed amplification along the ridge cannot be explained by sediment - induced amplification , but is consistent with predicted topographic amplification by a steep, narrow ridge. Although damage was largely a consequence of poor construction , the damage pattern inferred from analysis of remote sensing imagery provides evidence for a correspondence between small-scale (0.1 - 1.0 km) topographic relief and high damage. Mainshock shaking intensity can be estimated crudely from a consideration of macroseismic effects . We further present detailed, quantitative analysis of the marks left on a tile floor by an industrial battery rack displaced during the mainshock, at the location where we observed the highest weak motion amplifications. Results of this analysis indicate that mainshock shaking was significantly higher at this location (~0.5 g , MMI VIII) relative to the shaking in parts of Port-au-Prince that experienced light damage. Our results further illustrate how observations of rigid body horizontal displacement during earthquakes can be used to estimate peak ground accelerations in the absence of instrumental data .

Changing Water-Resources on Ile de la Gonave, Haiti

NASA Astrophysics Data System (ADS)

Troester, J. W.

2002-12-01

Ile de la Gonave is a 750-square-kilometer island off the western coast of Haiti. The island is composed of Eocene and Miocene limestones unconformably overlain by Pleistocene limestone. The highest elevation is 778 meters. Annual precipitation varies across the island because of the orographic effect and ranges from 800 to 1,400 millimeters. There is no surface water except immediately after large storms. Droughts, some extending for more than one year, and frequent crop failures due to droughts have been reported. Potential evaporation is estimated to be about 2,000 millimeters at the coast, but less at higher elevations. Consequently most rain is lost through evapotranspiration; recharge to the limestone aquifers apparently occurs only after large storms and is estimated to be about 4 percent of the mean annul precipitation based on a chloride mass balance. Depth to the water table ranges from less than 30 meters in the Eocene and Miocene limestones to over 60 meters in the 300-meter thick Quaternary limestone. Average annual precipitation at Port au-Prince (50 kilometers to the east and on the main island of Hispaniola) has decreased from about 1600 millimeters in 1860's to about 1300 mm in the 1950's. Precipitation data from Port-au-Prince after the 1950's are sporadic, making further comments about climate change difficult. Even without decreasing precipitation, which may be due in part to climate change or the deforestation of Haiti, the increasing population on Ile de la Gonave has and will continue to exacerbate the scarce water supply, particularly because of the small number of sources (springs, cave pools, and wells) where people can obtain water. Women take an average of almost three hours per day to travel an average of 2.5 kilometers (one-way) to obtain water for their families. Because of the difficulties in obtaining freshwater, the 100,000 inhabitants use an average of only 7 to 13 liters per person per day. Reconnaissance field analyses indicate

Prevalence of physical violence against children in Haiti: A national population-based cross-sectional survey✩

PubMed Central

Rivara, Frederick P.; Weiss, Noel S.; Lea, Veronica A.; Marcelin, Louis H.; Vertefeuille, John; Mercy, James A.

2018-01-01

Although physical violence against children is common worldwide, there are no national estimates in Haiti. To establish baseline national estimates, a three-stage clustered sampling design was utilized to administer a population-based household survey about victimization due to physical violence to 13–24 year old Haitians (n = 2,916), including those residing in camps or settlements. Descriptive statistics and weighted analysis techniques were used to estimate national lifetime prevalence and characteristics of physical violence against children. About two-thirds of respondents reported having experienced physical violence during childhood (67.0%; 95% CI 63.4–70.4), the percentage being similar in males and females. More than one-third of 13–17 year old respondents were victimized in the 12 months prior to survey administration (37.8%; 95% CI 33.6–42.1). The majority of violence was committed by parents and teachers; and the perceived intent was often punishment or discipline. While virtually all (98.8%; 95% CI 98.0–99.3) victims of childhood physical violence were punched, kicked, whipped or beaten; 11.0% (95% CI 9.2–13.2) were subject to abuse by a knife or other weapon. Injuries sustained from violence varied by victim gender and perpetrator, with twice as many females (9.6%; 95% CI 7.1–12.7) than males (4.0%; 95% CI 2.6–6.1) sustaining permanent injury or disfigurement by a family member or caregiver (p-value <.001). Our findings suggest that physical violence against children in Haiti is common, and may lead to severe injury. Characterization of the frequency and nature of this violence provides baseline estimates to inform interventions. PMID:26612595

Determinants of care seeking for mental health problems in rural Haiti: culture, cost, or competency.

PubMed

Wagenaar, Bradley H; Kohrt, Brandon A; Hagaman, Ashley K; McLean, Kristen E; Kaiser, Bonnie N

2013-04-01

This study examined patterns, determinants, and costs of seeking care for mild to moderate psychiatric distress in order to determine optimal approaches for expanding mental health care in rural Haiti. A cross-sectional, zone-stratified household survey of 408 adults was conducted in Haiti's Central Plateau. Multivariable logistic regression models were built to assess determinants of first-choice and lifetime health service use by provider type. Thirty-two percent of respondents endorsed God as their first choice for care if suffering from mental distress, and 29% of respondents endorsed clinics and hospitals as their first choice. Forty-seven percent of respondents chose potential providers on the basis of anticipated efficacy. Suicidal individuals were 7.6 times (95% confidence interval [CI]=1.4-42.0) as likely to prefer community-based providers (herbal healer, church priest or pastor, or Vodou priest) over hospitals or clinics. Depression severity was associated with increased odds (adjusted odds ratio [AOR]=1.8, CI=1.5-2.3) of ever having been to an herbal healer. Having a household member with mental health problems was associated with increased odds of ever having been to church pastors or priests (AOR=5.8, CI=2.8-12.0) and decreased odds of ever having been to hospitals or clinics (AOR=.3, CI=.1-.8). Median actual service costs were US $1 for hospitals or clinics, $6 for herbal healers, and $120 for Vodou priests. Three out of four rural Haitians said they would seek community resources over clinical care if suffering from mental distress. Therefore, isolated clinical interventions may have limited impact because of less frequent use. Efforts to expand mental health care should consider differential provider costs when selecting community resources for task shifting.

The Role of International Volunteers in the Growth of Surgical Capacity in Post-earthquake Haiti.

PubMed

Derenoncourt, Max Herby; Carré, Roselaine; Condé-Green, Alexandra; Rodnez, Alain; Sifri, Ziad C; Baltazar, Gerard A

2016-04-01

The 2010 Haiti earthquake severely strained local healthcare infrastructure. In the wake of this healthcare crisis, international organizations provided volunteer support. Studies demonstrate that this support improved short-term recovery; however, it is unclear how long-term surgical capacity has changed and what role volunteer surgical relief efforts have played. Our goal was to investigate the role of international surgical volunteers in the increase of surgical capacity following the 2010 Haiti earthquake. We retrospectively analyzed the operative reports of 3208 patients at a general, trauma and critical care hospital in Port-au-Prince from June 2010 through December 2013. We collected data on patient demographics and operation subspecialty. Surgeons and anesthesiologists were categorized by subspecialty training and as local healthcare providers or international volunteers. We performed analysis of variance to detect changes in surgical capacity over time and to estimate the role volunteers play in these changes. Overall number of monthly operations increased over the 2.5 years post-earthquake. The percentage of orthopedic operations declined while the percentage of other subspecialty operations increased (p = 0.0003). The percentage of operations performed by international volunteer surgeons did not change (p = 0.51); however, the percentage of operations staffed by volunteer anesthesiologists declined (p = 0.058). The percentage of operations performed by matching specialty- and subspecialty-trained international volunteers has not changed (p = 0.54). Haitian post-earthquake local and overall surgical capacity has steadily increased, particularly for provision of subspecialty operations. Surgical volunteers have played a consistent role in the recovery of surgical capacity. An increased focus on access to surgical services and resource-allocation for long-term surgical efforts particularly in the realm of subspecialty surgery may lead to full recovery of

Public–nonprofit partnership performance in a disaster context: the case of Haiti.

PubMed

Nolte, Isabella M; Boenigk, Silke

2011-01-01

During disasters, partnerships between public and nonprofit organizations are vital to provide fast relief to affected communities. In this article, we develop a process model to support a performance evaluation of such intersectoral partnerships. The model includes input factors, organizational structures, outputs and the long-term outcomes of public–nonprofit partnerships. These factors derive from theory and a systematic literature review of emergency, public, nonprofit, and network research. To adapt the model to a disaster context, we conducted a case study that examines public and nonprofit organizations that partnered during the 2010 Haiti earthquake. The case study results show that communication, trust, and experience are the most important partnership inputs; the most prevalent governance structure of public–nonprofit partnerships is a lead organization network. Time and quality measures should be considered to assess partnership outputs, and community, network, and organizational actor perspectives must be taken into account when evaluating partnership outcomes.

Feasibility of the Hydrogen Sulfide Test for the Assessment of Drinking Water Quality in Post-Earthquake Haiti

PubMed Central

Weppelmann, Thomas A.; Alam, Meer T.; Widmer, Jocelyn; Morrissey, David; Rashid, Mohammed H.; Beau De Rochars, Valery M.; Morris, J. Glenn; Ali, Afsar; Johnson, Judith A.

2014-01-01

In 2010 a magnitude 7.0 earthquake struck Haiti, severely damaging the drinking and waste water infrastructure and leaving millions homeless. Compounding this problem, the introduction of Vibrio cholera resulted in a massive cholera outbreak that infected over 700,000 people and threatened the safety of Haiti’s drinking water. To mitigate this public health crisis, non-government organizations installed thousands of wells to provide communities with safe drinking water. However, despite increased access, Haiti currently lacks the monitoring capacity to assure the microbial safety of any of its water resources. For these reasons, this study was designed to assess the feasibility of using a simple, low cost method to detect indicators of fecal contamination of drinking water that could be implemented at the community level. Water samples from 358 sources of drinking water in the Léogâne flood basin were screened with a commercially available hydrogen sulfide test and a standard membrane method for the enumeration of thermotolerant coliforms. When compared with the gold standard method, the hydrogen sulfide test had a sensitivity of 65% and a specificity of 93%. While the sensitivity of the assay increased at higher fecal coliform concentrations, it never exceeded 88%, even with fecal coliform concentrations greater than 100 colony forming units per 100 milliliters. While its simplicity makes the hydrogen sulfide test attractive for assessing water quality in low resource settings, the low sensitivity raises concerns about its use as the sole indicator of the presence or absence of fecal coliforms in individual or community water sources. PMID:25182685

Assessment of Drinking Water Sold from Private Sector Kiosks in Post-Earthquake Port-au-Prince, Haiti

PubMed Central

Steenland, Maria; Dismer, Amber; Pierre-Louis, Jocelyne; Murphy, Jennifer L.; Kahler, Amy; Mull, Bonnie; Etheart, Melissa D.; Rossignol, Emmanuel; Boncy, Jacques; Hill, Vincent; Handzel, Thomas

2017-01-01

Abstract. Consumption of drinking water from private vendors has increased considerably in Port-au-Prince, Haiti, in recent decades. A major type of vendor is private kiosks, advertising reverse osmosis-treated water for sale by volume. To describe the scale and geographical distribution of private kiosks in metropolitan Port-au-Prince, an inventory of private kiosks was conducted from July to August 2013. Coordinates of kiosks were recorded with global positioning system units and a brief questionnaire was administered with the operator to document key kiosk characteristics. To assess the quality of water originating from private kiosks, water quality analyses were also conducted on a sample of those inventoried as well as from the major provider company sites. The parameters tested were Escherichia coli, free chlorine residual, pH, turbidity, and total dissolved solids. More than 1,300 kiosks were inventoried, the majority of which were franchises of four large provider companies. Approximately half of kiosks reported opening within 12 months of the date of the inventory. The kiosk treatment chain and sales price was consistent among a majority of the kiosks. Of the 757 kiosks sampled for water quality, 90.9% of samples met World Health Organization (WHO) microbiological guideline at the point of sale for nondetectable E. coli in a 100-mL sample. Of the eight provider company sites tested, all samples met the WHO microbiological guideline. Because of the increasing role of the private sector in drinking water provision in Port-au-Prince and elsewhere in Haiti, this assessment was an important first step for government regulation of this sector. PMID:29064355

Clinical Features of Human Immunodeficiency Virus-Infected Patients Presenting with Cholera in Port-au-Prince, Haiti.

PubMed

Sévère, Karine; Anglade, Stravinsky B; Bertil, Claudin; Duncan, Aynsley; Joseph, Patrice; Deroncenay, Alexandra; Mabou, Marie M; Ocheretina, Oksana; Reif, Lindsey; Seo, Grace; Pape, Jean W; Fitzgerald, Daniel W

2016-11-02

Human immunodeficiency virus (HIV) infection has been postulated to alter the natural history of cholera, including increased susceptibility to infection, severity of illness, and chronic carriage of Vibrio cholerae Haiti has a generalized HIV epidemic with an adult HIV prevalence of 1.9% and recently suffered a cholera epidemic. We conducted a prospective study at the cholera treatment center (CTC) of GHESKIO in Haiti to characterize the coinfection. Adults admitted at the CTC for acute diarrhea were invited to participate in the study. Vital signs, frequency, and volume of stools and/or vomiting were monitored, and single-dose doxycycline was administered. After counseling, participants were screened for HIV by enzyme-linked immunosorbent assay and for cholera by culture. Of 729 adults admitted to the CTC, 99 (13.6%) had HIV infection, and 457 (63%) had culture-confirmed cholera. HIV prevalence was three times higher in patients without cholera (23%, 63/272) than in those with culture-confirmed cholera (7.9%, 36/457). HIV prevalence in patients with culture-confirmed cholera (7.9%) was four times higher than the adult prevalence in Port-au-Prince (1.9%). Of the 36 HIV-infected patients with cholera, 25 (69%) had moderate/severe dehydration versus 302/421 (72%) in the HIV negative. Of 30 HIV-infected patients with weekly stool cultures performed after discharge, 29 (97%) were negative at week 1. Of 50 HIV-negative patients with weekly stool cultures, 49 (98%) were negative at week 1. In countries with endemic HIV infection, clinicians should consider screening patients presenting with suspected cholera for HIV coinfection. © The American Society of Tropical Medicine and Hygiene.

The aetiology of vaginal symptoms in rural Haiti.

PubMed

Bristow, Claire C; Desgrottes, Tania; Cutler, Lauren; Cutler, David; Devarajan, Karthika; Ocheretina, Oksana; Pape, Jean William; Klausner, Jeffrey D

2014-08-01

Vaginal symptoms are a common chief complaint amongst women visiting outpatient clinics in rural Haiti. A systematic sample of 206 consecutive women over age 18 with gynaecological symptoms underwent gynaecologic examination and laboratory testing for chlamydia, gonorrhoea, syphilis, HIV infection, trichomoniasis, candidiasis, and bacterial vaginosis. Among 206 women, 174 (84%) presented with vaginal discharge, 165 (80%) with vaginal itching, 123 (60%) with vaginal pain or dysuria, and 18 (9%) with non-traumatic vaginal sores or boils. Laboratory results were positive forChlamydia trachomatisin 5.4% (11/203), syphilis in 3.5% (7/202), HIV in 1.0% (2/200), andNeisseria gonorrhoeaein 1.0% (2/203). Among those that had microscopy, hyphae suggestive of candidiasis were visualized in 2.2% (1/45) and no cases of trichomoniasis were diagnosed 0% (0/45). Bacterial vaginosis was diagnosed in 28.3% (13/46). The prevalence of chlamydia was 4.9 (95% CI: 1.3-17.7) times greater among those 25 years of age and under (10.8%) than those older (2.3%). Chlamydia and bacterial vaginosis were the most common sexually transmitted infection and vaginal condition, respectively, in this study of rural Haitian adult women. The higher risk of chlamydia in younger women suggests education and screening programmes in young women should be considered. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Adapting and Implementing a Community Program to Improve Retention in Care among Patients with HIV in Southern Haiti: "Group of 6".

PubMed

Naslund, John A; Dionne-Odom, Jodie; Junior Destiné, Cléonas; Jogerst, Kristen M; Renold Sénécharles, Redouin; Jean Louis, Michelande; Desir, Jasmin; Néptune Ledan, Yvette; Beauséjour, Jude Ronald; Charles, Roland; Werbel, Alice; Talbot, Elizabeth A; Joseph, Patrice; Pape, Jean William; Wright, Peter F

2014-01-01

Objective. In Mozambique, a patient-led Community ART Group model developed by Médecins Sans Frontières improved retention in care and adherence to antiretroviral therapy (ART) among persons with HIV. We describe the adaptation and implementation of this model within the HIV clinic located in the largest public hospital in Haiti's Southern Department. Methods. Our adapted model was named Group of 6. Hospital staff enabled stable patients with HIV receiving ART to form community groups with 4-6 members to facilitate monthly ART distribution, track progress and adherence, and provide support. Implementation outcomes included recruitment success, participant retention, group completion of monthly monitoring forms, and satisfaction surveys. Results. Over one year, 80 patients from nine communities enrolled into 15 groups. Six participants left to receive HIV care elsewhere, two moved away, and one died of a non-HIV condition. Group members successfully completed monthly ART distribution and returned 85.6% of the monthly monitoring forms. Members reported that Group of 6 made their HIV management easier and hospital staff reported that it reduced their workload. Conclusions. We report successful adaptation and implementation of a validated community HIV-care model in Southern Haiti. Group of 6 can reduce barriers to ART adherence, and will be integrated as a routine care option.

'Life under the tent is not safe, especially for young women': understanding intersectional violence among internally displaced youth in Leogane, Haiti.

PubMed

Logie, Carmen H; Daniel, CarolAnn; Ahmed, Uzma; Lash, Rebecca

Haiti's 2010 earthquake devastated social, health, and economic infrastructure and left 2 million persons homeless. Over 6 years later 61,000 people remain displaced, most lacking protection, services, and durable solutions. Structural contexts elevate risks of gender-based violence (GBV) targeting internally displaced (ID) girls and women. We used an intersectionality framework to explore lived experiences and understanding of violence among ID young men and women in Leogane, Haiti. We conducted six focus groups, three with ID young women (n = 30) and three with ID young men (n = 30) aged 18-24 years, and 11 in-depth individual interviews with frontline workers in Leogane. Focus groups and interviews were conducted in Kreyol, transcribed verbatim, translated into English, and analyzed using narrative thematic techniques. Findings revealed violence experienced by ID youth was (re)produced at the intersection of gender, poverty, displacement, and age. Multi-level forms of violence included structural (e.g. poverty), community (e.g. gender norms, and interpersonal (e.g. family expectations) dimensions. Coping strategies spanned intrapersonal (hope), community (social support), and structural (employment/education) dimensions. Interventions to reduce violence should be tailored to address the social inequities that emerge at the intersection of youth, poverty, displacement, and hegemonic gender norms.

Knowledge, attitudes and practices regarding rabies risk in community members and healthcare professionals: Pétionville, Haiti, 2013.

PubMed

Fenelon, N; Dely, P; Katz, M A; Schaad, N D; Dismer, A; Moran, D; Laraque, F; Wallace, R M

2017-06-01

Haiti has the highest human rabies burden in the Western Hemisphere. There is no published literature describing the public's perceptions of rabies in Haiti, information that is critical to developing effective interventions and government policies. We conducted a knowledge, attitudes and practices survey of 550 community members and 116 health professionals in Pétionville, Haiti in 2013 to understand the perception of rabies in these populations. The majority of respondents (85%) knew that dogs were the primary reservoir for rabies, yet only 1% were aware that bats and mongooses could transmit rabies. Animal bites were recognized as a mechanism of rabies transmission by 77% of the population and 76% were aware that the disease could be prevented by vaccination. Of 172 persons reporting a bite, only 37% sought medical treatment. The annual bite incidence rate in respondents was 0·9%. Only 31% of bite victims reported that they started the rabies vaccination series. Only 38% of respondents reported that their dog had been vaccinated against rabies. The majority of medical professionals recognized that dogs were the main reservoir for rabies (98%), but only 28% reported bats and 14% reported mongooses as posing a risk for rabies infection. Bites were reported as a mechanism of rabies transmission by 73% of respondents; exposure to saliva was reported by 20%. Thirty-four percent of medical professionals reported they would wash a bite wound with soap and water and 2·8% specifically mentioned rabies vaccination as a component of post-bite treatment. The majority of healthcare professionals recommended some form of rabies assessment for biting animals; 68·9% recommended a 14-day observation period, 60·4% recommended a veterinary consultation, and 13·2% recommended checking the vaccination status of the animal. Fewer than 15% of healthcare professionals had ever received training on rabies prevention and 77% did not know where to go to procure rabies vaccine for

Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014–15: a retrospective follow-up survey

PubMed Central

Etheart, Melissa Dominique; Kligerman, Maxwell; Augustin, Pierre Dilius; Blanton, Jesse D; Monroe, Benjamin; Fleurinord, Ludder; Millien, Max; Crowdis, Kelly; Fenelon, Natael; Wallace, Ryan MacLaren

2017-01-01

Summary Background Haiti has an integrated bite case management (IBCM) programme to counsel animal-bite victims on the risk of rabies and appropriate treatment, as well as the Haiti Animal Rabies Surveillance Program (HARSP) to examine the animals. We assessed the usefulness of the IBCM programme to promote best practices for rabies prophylaxis after exposure in a low-income rabies-endemic setting. Methods We did a retrospective follow-up survey of randomly selected bite victims who were counselled by Haiti's IBCM programme between May 15, 2014, and Sept 15, 2015. We classified participants by HARSP decisions of confirmed, probable, suspected, or non-rabies exposures. We compared health-care outcomes in people who sought medical care before IBCM counselling with those in people who sought care after counselling. We used decision trees to estimate the probability of actions taken in the health-care system, and thereby human deaths. Findings During the study period, 1478 dog bites were reported to HARSP for assessment. 37 (3%) were confirmed exposures, 76 (5%) probable exposures, 189 (13%) suspected exposures, and 1176 (80%) non-rabies exposures. 115 of these cases were followed up in the survey. IBCM counselling was associated with a 1.2 times increase in frequency of bite victims seeking medical care and of 2.4 times increase in vaccination uptake. We estimated that there would be four human rabies deaths among the 1478 people assessed by IBCM during the survey period, and 11 in the absence of this programme, which would equate to a 65% decrease in rabies deaths. Among three people dead at the time of the follow-up survey, one was deemed to be due to rabies after a probable rabies exposure. Interpretation Adherence to medical providers' recommendations might be improved through counselling provided by IBCM programmes. PMID:28911750

The role of service readiness and health care facility factors in attrition from Option B+ in Haiti: a joint examination of electronic medical records and service provision assessment survey data.

PubMed

Lipira, Lauren; Kemp, Christopher; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner; Puttkammer, Nancy

2018-01-01

Option B+ is a strategy wherein pregnant or breastfeeding women with HIV are enrolled in lifelong antiretroviral therapy (ART) for prevention of mother-to-child transmission (PMTCT) of HIV. In Haiti, attrition from Option B+ is problematic and variable across health care facilities. This study explores service readiness and other facility factors as predictors of Option B+ attrition in Haiti. This analysis used longitudinal data from 2012 to 2014 from the iSanté electronic medical record system and cross-sectional data from Haiti's 2013 Service Provision Assessment. Predictors included Service Availability and Readiness Assessment (SARA) measures for antenatal care (ANC), PMTCT, HIV care services and ART services; general facility characteristics and patient-level factors. Multivariable Cox proportional hazards models modelled the time to first attrition. Analysis of data from 3147 women at 63 health care facilities showed no significant relationships between SARA measures and attrition. Having integrated ANC/PMTCT care and HIV-related training were significant protective factors. Being a public-sector facility, having a greater number of quality improvement activities and training in ANC were significant risk factors. Several facility-level factors were associated with Option B+ attrition. Future research is needed to explore unmeasured facility factors, clarify causal relationships, and incorporate community-level factors into the analysis of Option B+ attrition. © The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Shelter recovery in urban Haiti after the earthquake: the dual role of social capital.

PubMed

Rahill, Guitele J; Ganapati, N Emel; Clérismé, J Calixte; Mukherji, Anuradha

2014-04-01

This paper documents the culture-specific understanding of social capital among Haitians and examines its benefits and downsides in post-disaster shelter recovery following the 12 January 2010 earthquake. The case study of shelter recovery processes in three socioeconomically diverse communities (Pétion-Ville, Delmas and Canapé Vert) in Port-au-Prince suggests that social capital plays dual roles in post-disaster shelter recovery of the displaced population in Haiti. On the one hand, it provides enhanced access to shelter-related resources for those with connections. On the other hand, it accentuates pre-existing inequalities or creates new inequalities among displaced Haitians. In some cases, such inequalities lead to tensions between the haves and have-nots and instigate violence among the displaced. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Early disaster response in Haiti: the Israeli field hospital experience.

PubMed

Kreiss, Yitshak; Merin, Ofer; Peleg, Kobi; Levy, Gad; Vinker, Shlomo; Sagi, Ram; Abargel, Avi; Bartal, Carmi; Lin, Guy; Bar, Ariel; Bar-On, Elhanan; Schwaber, Mitchell J; Ash, Nachman

2010-07-06

The earthquake that struck Haiti in January 2010 caused an estimated 230,000 deaths and injured approximately 250,000 people. The Israel Defense Forces Medical Corps Field Hospital was fully operational on site only 89 hours after the earthquake struck and was capable of providing sophisticated medical care. During the 10 days the hospital was operational, its staff treated 1111 patients, hospitalized 737 patients, and performed 244 operations on 203 patients. The field hospital also served as a referral center for medical teams from other countries that were deployed in the surrounding areas. The key factor that enabled rapid response during the early phase of the disaster from a distance of 6000 miles was a well-prepared and trained medical unit maintained on continuous alert. The prompt deployment of advanced-capability field hospitals is essential in disaster relief, especially in countries with minimal medical infrastructure. The changing medical requirements of people in an earthquake zone dictate that field hospitals be designed to operate with maximum flexibility and versatility regarding triage, staff positioning, treatment priorities, and hospitalization policies. Early coordination with local administrative bodies is indispensable.

Satellite Map of Port-au-Prince, Haiti-2010-Natural Color

USGS Publications Warehouse

Cole, Christopher J.; Sloan, Jeff

2010-01-01

The U.S. Geological Survey produced 1:24,000-scale post-earthquake image base maps incorporating high- and medium-resolution remotely sensed imagery following the 7.0 magnitude earthquake near the capital city of Port au Prince, Haiti, on January 12, 2010. Commercial 2.4-meter multispectral QuickBird imagery was acquired by DigitalGlobe on January 15, 2010, following the initial earthquake. Ten-meter multispectral ALOS AVNIR-2 imagery was collected by the Japanese Space Agency (JAXA) on January 12, 2010. These data were acquired under the Remote Sensing International Charter, a global team of space and satellite agencies that provide timely imagery in support of emergency response efforts worldwide. The images shown on this map were employed to support earthquake response efforts, specifically for use in determining ground deformation, damage assessment, and emergency management decisions. The raw, unprocessed imagery was geo-corrected, mosaicked, and reproduced onto a cartographic 1:24,000-scale base map. These maps are intended to provide a temporally current representation of post-earthquake ground conditions, which may be of use to decision makers and to the general public.

ART Attrition across Health Facilities Implementing Option B+ in Haiti.

PubMed

Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner

2018-01-01

Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.

T cell subtypes and reciprocal inflammatory mediator expression differentiate P. falciparum memory recall responses in asymptomatic and symptomatic malaria patients in southeastern Haiti

PubMed Central

Campo, Joseph J.; Cicéron, Micheline; Raccurt, Christian P.; Beau De Rochars, Valery E. M.

2017-01-01

Asymptomatic Plasmodium falciparum infection is responsible for maintaining malarial disease within human populations in low transmission countries such as Haiti. Investigating differential host immune responses to the parasite as a potential underlying mechanism could help provide insight into this highly complex phenomenon and possibly identify asymptomatic individuals. We performed a cross-sectional analysis of individuals who were diagnosed with malaria in Sud-Est, Haiti by comparing the cellular and humoral responses of both symptomatic and asymptomatic subjects. Plasma samples were analyzed with a P. falciparum protein microarray, which demonstrated serologic reactivity to 3,877 P. falciparum proteins of known serologic reactivity; however, no antigen-antibody reactions delineating asymptomatics from symptomatics were identified. In contrast, differences in cellular responses were observed. Flow cytometric analysis of patient peripheral blood mononuclear cells co-cultured with P. falciparum infected erythrocytes demonstrated a statistically significant increase in the proportion of T regulatory cells (CD4+ CD25+ CD127-), and increases in unique populations of both NKT-like cells (CD3+ CD8+ CD56+) and CD8mid T cells in asymptomatics compared to symptomatics. Also, CD38+/HLA-DR+ expression on γδ T cells, CD8mid (CD56-) T cells, and CD8mid CD56+ NKT-like cells decreased upon exposure to infected erythrocytes in both groups. Cytometric bead analysis of the co-culture supernatants demonstrated an upregulation of monocyte-activating chemokines/cytokines in asymptomatics, while immunomodulatory soluble factors were elevated in symptomatics. Principal component analysis of these expression values revealed a distinct clustering of individual responses within their respective phenotypic groups. This is the first comprehensive investigation of immune responses to P. falciparum in Haiti, and describes unique cell-mediated immune repertoires that delineate individuals

T cell subtypes and reciprocal inflammatory mediator expression differentiate P. falciparum memory recall responses in asymptomatic and symptomatic malaria patients in southeastern Haiti.

PubMed

Lehmann, Jason S; Campo, Joseph J; Cicéron, Micheline; Raccurt, Christian P; Boncy, Jacques; Beau De Rochars, Valery E M; Cannella, Anthony P

2017-01-01

Asymptomatic Plasmodium falciparum infection is responsible for maintaining malarial disease within human populations in low transmission countries such as Haiti. Investigating differential host immune responses to the parasite as a potential underlying mechanism could help provide insight into this highly complex phenomenon and possibly identify asymptomatic individuals. We performed a cross-sectional analysis of individuals who were diagnosed with malaria in Sud-Est, Haiti by comparing the cellular and humoral responses of both symptomatic and asymptomatic subjects. Plasma samples were analyzed with a P. falciparum protein microarray, which demonstrated serologic reactivity to 3,877 P. falciparum proteins of known serologic reactivity; however, no antigen-antibody reactions delineating asymptomatics from symptomatics were identified. In contrast, differences in cellular responses were observed. Flow cytometric analysis of patient peripheral blood mononuclear cells co-cultured with P. falciparum infected erythrocytes demonstrated a statistically significant increase in the proportion of T regulatory cells (CD4+ CD25+ CD127-), and increases in unique populations of both NKT-like cells (CD3+ CD8+ CD56+) and CD8mid T cells in asymptomatics compared to symptomatics. Also, CD38+/HLA-DR+ expression on γδ T cells, CD8mid (CD56-) T cells, and CD8mid CD56+ NKT-like cells decreased upon exposure to infected erythrocytes in both groups. Cytometric bead analysis of the co-culture supernatants demonstrated an upregulation of monocyte-activating chemokines/cytokines in asymptomatics, while immunomodulatory soluble factors were elevated in symptomatics. Principal component analysis of these expression values revealed a distinct clustering of individual responses within their respective phenotypic groups. This is the first comprehensive investigation of immune responses to P. falciparum in Haiti, and describes unique cell-mediated immune repertoires that delineate individuals

Signature of Transpressional Tectonics in the Holocene Stratigraphy of Lake Azuei, Haiti: Preliminary Results From a High-Resolution Subbottom Profiling Survey

NASA Astrophysics Data System (ADS)

Cormier, M. H.; Sloan, H.; Boisson, D.; Brown, B.; Guerrier, K.; Hearn, C. K.; Heil, C. W., Jr.; Kelly, R. P.; King, J. W.; Knotts, P.; Lucier, O. F.; Momplaisir, R.; Stempel, R.; Symithe, S. J.; Ulysse, S. M. J.; Wattrus, N. J.

2017-12-01

The left-lateral Enriquillo-Plantain Garden Fault (EPGF) is one of two transform systems that define the Northern Caribbean plate boundary zone. Relative motion across its trace ( 10 mm/yr) evolves from nearly pure strike-slip in western Haiti to transpressional in eastern Haiti, where the fault system may terminate against a south-dipping oblique reverse fault. Lake Azuei is a large (10 km x 25 km) and shallow (< 30 m deep) lake that lies in the direct extension of the EPGF in eastern Haiti. A single core previously collected in the lake suggests high sedimentation rates at its depocenter ( 6 mm/yr). The shallow lake stratigraphy is therefore expected to faithfully record any tectonic deformation that occurred within the past few thousand years. In January 2017, we acquired a grid of high-resolution ( 10 cm), shallow penetration ( 4 to 5 m) subbottom seismic (CHIRP) profiles spaced 1.2 km apart across the entire lake. A new bathymetric map compiled from these CHIRP data and some prior echosounder survey reveals a flat lake floor (<0.01°) surrounded by steep ( 5°) shoreline slopes. The CHIRP profiles highlight several gentle folds that protrude from the flat lakebed near the southern shore, an area where transpressional deformation is presumably focused. Thin (< 20 cm) horizontal strata from the lakebed can be traced onto the flanks of these gentle folds and pinch out in an upward curve. They also often pinch upward onto the base of the shoreline slopes, indicating that young sediments on the lakebed bypassed the folds as well as the shoreline slopes. We interpret this feature as diagnostic of sediments deposited by turbidity currents. The fact that young turbidites pinch out in upward curves suggests that the folds are actively growing, and that active contractional structures (folds and/or blind thrust faults) control much of the periphery of the lake. A few sediment cores were strategically located where beds are pinching out in order to maximize stratigraphic

The Economic and Social Burden of Traumatic Injuries: Evidence from a Trauma Hospital in Port-au-Prince, Haiti.

PubMed

Zuraik, Christopher; Sampalis, John; Brierre, Alexa

2018-06-01

The cost of traumatic injury is unknown in Haiti. This study aims to examine the burden of traumatic injury of patients treated and evaluated at a trauma hospital in the capital city of Port-au-Prince. A retrospective cross-sectional chart review study was conducted at the Hospital Bernard Mevs Project Medishare for all patients evaluated for traumatic injury from December 2015 to January 2016, as described elsewhere (Zuraik and Sampalis in World J Surg, https://doi.org/10.1007/s00268-017-4088-2 , 2017). Direct medical costs were obtained from patient hospital bills. Indirect and intangible costs were calculated using the human capital approach. A total of 410 patients were evaluated for traumatic injury during the study period. Total costs for all patients were $501,706 with a mean cost of $1224. Indirect costs represented 63% of all costs, direct medical costs 19%, and intangible costs 18%. Surgical costs accounted for the majority of direct medical costs (29%). Patients involved in road traffic accidents accounted for the largest number of injuries (41%) and the largest percentage of total costs (51%). Patients with gunshot wounds had the highest total mean costs ($1566). Mean costs by injury severity ranged from $62 for minor injuries, $1269 for serious injuries, to $13,675 for critical injuries. Injuries lead to a significant economic burden for individuals treated at a semi-private trauma hospital in the capital city of Port-au-Prince, Haiti. Programs aimed at reducing injuries, particularly road traffic accidents, would likely reduce the economic burden to the nation.

The United Nations Material Assistance to Survivors of Cholera in Haiti: Consulting Survivors and Rebuilding Trust.

PubMed

Pham, Phuong N; Gibbons, Niamh; Vinck, Patrick

2017-10-23

In August 2016, the United Nations (U.N.) Secretary General acknowledged the U.N.'s role in the cholera epidemic that has beset Haiti since 2010. Two months later, the Secretary General issued a historic apology to the Haitian people before the U.N. General Assembly, for the organization's insufficient response to the cholera outbreak. These steps are part of the U.N.'s "new approach" to cholera in Haiti, which also includes launching a material assistance package for those most affected by cholera. This paper draws on the authors' experience and findings from consultations with more than 60,000 victims and communities affected by disasters and violence in a dozen countries. We reviewed the literature on best practices for consultation with and outreach to communities affected by development and transitional justice programming, and reviewed our own findings from previous studies with a view to identifying recommendations for ensuring that the assistance package reflects the views of people affected by cholera. The assistance package program is an opportunity to rebuild the relationship between the victims and the United Nations. This can only be achieved if victims are informed and engaged in the process. This consultation effort is also an opportunity to answer a set of key questions related to the nature, structure, and implementation of the victims' assistance program, but also how the program may be designed to contribute to rebuilding Haitians' confidence in the U.N. as an institution that promotes peace, human rights, and development. We recommend that the consultations must be accompanied by an outreach effort that provides clear, accurate information on the assistance program, so that it begins to establish a dialogue between the U.N. and cholera victims. Finally, we conclude by offering a number of concrete next steps that the U.N. can take to kick start the consultation process.

The impact of internal displacement on child mortality in post-earthquake Haiti: a difference-in-differences analysis.

PubMed

Chen, Bradley; Halliday, Timothy J; Fan, Victoria Y

2016-07-19

The Haiti earthquake in 2010 resulted in 1.5 million internally displaced people (IDP), yet little is known about the impact of displacement on health. In this study, we estimate the impact of displacement on infant and child mortality and key health-behavior mechanisms. We employ a difference-in-differences (DID) design with coarsened exact matching (CEM) to ensure comparability among groups with different displacement status using the 2012 Haiti Demographic and Health Survey (DHS). The participants are 21,417 births reported by a nationally representative sample of 14,287 women aged 15-49. The main independent variables are household displacement status which includes households living in camps, IDP households (not in camps), and households not displaced. The main outcomes are infant and child mortality; health status (height-for-age, anemia); uptake of public health interventions (bed net use, spraying against mosquitoes, and vaccinations); and other conditions (hunger; cholera). Births from the camp households have higher infant mortality (OR = 2.34, 95 % CI 1.15 to 4.75) and child mortality (OR = 2.34, 95 % CI 1.10 to 5.00) than those in non-camp IDP households following the earthquake. These odds are higher despite better access to food, water, bed net use, mosquito spraying, and vaccines among camp households. IDP populations are heterogeneous and households that are displaced outside of camps may be self-selected or self-insured. Meanwhile, even households not displaced by a disaster may face challenges in access to basic necessities and health services. Efforts are needed to identify vulnerable populations to provide targeted assistance in post-disaster relief.

Women's experience of intimate partner violence in Haiti.

PubMed

Gage, Anastasia J

2005-07-01

This study examined individual, partner, and community characteristics associated with the occurrence of intimate partner violence among ever-married women of reproductive age, using data from the 2000 Haiti Demographic and Health Survey. Separate logistic regressions were analyzed to assess women's risks of experiencing emotional, physical and sexual violence and multiple forms of intimate partner violence in the past 12 months. Twenty-nine percent of women in the sample experienced some form of intimate partner violence in the past 12 months, with 13 percent having experienced at least two different forms of violence. Significant positive associations with all forms of violence were found for lack of completion of primary school, history of violence exposure in women's families of origin either through witnessing violence between parents while growing up or direct experience of physical violence perpetrated by family members, partner's jealousy, partner's need for control, partner's history of drunkenness, and female-dominated financial decision-making. Significant positive associations were found between men's physical abuse of children at the community level and women's risk of experiencing emotional and physical violence. Neighborhood poverty and male unemployment, number of children living at home, women's attitudinal acceptance of wife beating, and male-dominated financial decision-making were additional risk factors for sexual violence. Women's economic independence was a protective factor for emotional and physical violence, while relationship quality was protective for all forms of violence and multiple victimizations.

Evaluation of Knowledge and Practices Regarding Cholera, Water Treatment, Hygiene, and Sanitation before and after an Oral Cholera Vaccination Campaign—Haiti, 2013–2014

PubMed Central

Childs, Lana; François, Jeannot; Choudhury, Alina; Wannemuehler, Kathleen; Dismer, Amber; Hyde, Terri B.; Yen, Catherine Y.; Date, Kashmira A.; Juin, Stanley; Katz, Mark A.; Kantor, Erica Felker; Routh, Janell; Etheart, Melissa; Wright, Tracie; Adrien, Paul; Tohme, Rania A.

2016-01-01

In 2013, the Government of Haiti implemented its first oral cholera vaccine (OCV) campaign in Petite Anse, an urban setting, and Cerca Carvajal, a rural commune. We conducted and compared responses to two independent cross-sectional knowledge and practices household surveys pre- (N = 297) and post- (N = 302) OCV campaign in Petite Anse. No significant differences in knowledge about causes, symptoms, and prevention of cholera were noted. Compared with precampaign respondents, fewer postcampaign respondents reported treating (66% versus 27%, P < 0.001) and covering (96% versus 89%, P = 0.02) their drinking water. Compared with precampaign, postcampaign survey household observations showed increased availability of soap (16.2% versus 34.5%, P = 0.001) and handwashing stations (14.7% versus 30.1%, P = 0.01), but no significant changes in handwashing practices were reported. Although there was no change in knowledge, significant decreases in water treatment practices necessary for cholera and other diarrheal diseases prevention were noted in the postcampaign survey. Future OCV campaigns in Haiti should be used as an opportunity to emphasize the importance of maintaining good water, sanitation, and hygiene practices, and include a comprehensive, integrated approach for cholera control. PMID:27799642

Effect of counselling on health-care-seeking behaviours and rabies vaccination adherence after dog bites in Haiti, 2014-15: a retrospective follow-up survey.

PubMed

Etheart, Melissa Dominique; Kligerman, Maxwell; Augustin, Pierre Dilius; Blanton, Jesse D; Monroe, Benjamin; Fleurinord, Ludder; Millien, Max; Crowdis, Kelly; Fenelon, Natael; Wallace, Ryan MacLaren

2017-10-01

Haiti has an integrated bite case management (IBCM) programme to counsel animal-bite victims on the risk of rabies and appropriate treatment, as well as the Haiti Animal Rabies Surveillance Program (HARSP) to examine the animals. We assessed the usefulness of the IBCM programme to promote best practices for rabies prophylaxis after exposure in a low-income rabies-endemic setting. We did a retrospective follow-up survey of randomly selected bite victims who were counselled by Haiti's IBCM programme between May 15, 2014, and Sept 15, 2015. We classified participants by HARSP decisions of confirmed, probable, suspected, or non-rabies exposures. We compared health-care outcomes in people who sought medical care before IBCM counselling with those in people who sought care after counselling. We used decision trees to estimate the probability of actions taken in the health-care system, and thereby human deaths. During the study period, 1478 dog bites were reported to HARSP for assessment. 37 (3%) were confirmed exposures, 76 (5%) probable exposures, 189 (13%) suspected exposures, and 1176 (80%) non-rabies exposures. 115 of these cases were followed up in the survey. IBCM counselling was associated with a 1·2 times increase in frequency of bite victims seeking medical care and of 2·4 times increase in vaccination uptake. We estimated that there would be four human rabies deaths among the 1478 people assessed by IBCM during the survey period, and 11 in the absence of this programme, which would equate to a 65% decrease in rabies deaths. Among three people dead at the time of the follow-up survey, one was deemed to be due to rabies after a probable rabies exposure. Adherence to medical providers' recommendations might be improved through counselling provided by IBCM programmes. None. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Implementation of an alert and response system in Haiti during the early stage of the response to the cholera epidemic.

PubMed

Santa-Olalla, Patricia; Gayer, Michelle; Magloire, Roc; Barrais, Robert; Valenciano, Marta; Aramburu, Carmen; Poncelet, Jean Luc; Gustavo Alonso, Juan Carlos; Van Alphen, Dana; Heuschen, Florence; Andraghetti, Roberta; Lee, Robert; Drury, Patrick; Aldighieri, Sylvain

2013-10-01

The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and

Implementation of an Alert and Response System in Haiti during the Early Stage of the Response to the Cholera Epidemic

PubMed Central

Santa-Olalla, Patricia; Gayer, Michelle; Magloire, Roc; Barrais, Robert; Valenciano, Marta; Aramburu, Carmen; Poncelet, Jean Luc; Gustavo Alonso, Juan Carlos; Van Alphen, Dana; Heuschen, Florence; Andraghetti, Roberta; Lee, Robert; Drury, Patrick; Aldighieri, Sylvain

2013-01-01

The start of the cholera epidemic in Haiti quickly highlighted the necessity of the implementation of an Alert and Response (A&R) System to complement the existing national surveillance system. The national system had been able to detect and confirm the outbreak etiology but required external support to monitor the spread of cholera and coordinate response, because much of the information produced was insufficiently timely for real-time monitoring and directing of a rapid, targeted response. The A&R System was designed by the Pan American Health Organization/World Health Organization in collaboration with the Haiti Ministry of Health, and it was based on a network of partners, including any institution, structure, or individual that could identify, verify, and respond to alerts. The defined objectives were to (1) save lives through early detection and treatment of cases and (2) control the spread through early intervention at the community level. The operational structure could be broken down into three principle categories: (1) alert (early warning), (2) verification and assessment of the information, and (3) efficient and timely response in coordination with partners to avoid duplication. Information generated by the A&R System was analyzed and interpreted, and the qualitative information was critical in qualifying the epidemic and defining vulnerable areas, particularly because the national surveillance system reported incomplete data for more than one department. The A&R System detected a number of alerts unrelated to cholera and facilitated rapid access to that information. The sensitivity of the system and its ability to react quickly was shown in May of 2011, when an abnormal increase in alerts coming from several communes in the Sud-Est Department in epidemiological weeks (EWs) 17 and 18 were noted and disseminated network-wide and response activities were implemented. The national cholera surveillance system did not register the increase until EWs 21 and

Using a Model of Team Collaboration to Investigate Inter-Organizational Collaboration During the Relief Effort of the January 2010 Haiti Earthquake

DTIC Science & Technology

2011-06-01

adoption among aid workers. The site was designed to be easy to use in order to facilitate use by personnel who may not be technologically savvy...SOUTHCOM establishes Joint Task Force – Haiti and designates it as the lead command and control organization for the DoD’s relief efforts. • 15 January...of empty seats left on flights out of PaP airport, with people unable to utilize them. TIE PD 5. A lot of equipment was damaged or lost because

Genetic diversity in the merozoite surface protein 1 and 2 genes of Plasmodium falciparum from the Artibonite Valley of Haiti.

PubMed

Londono-Renteria, Berlin; Eisele, Thomas P; Keating, Joseph; Bennett, Adam; Krogstad, Donald J

2012-01-01

Describing genetic diversity of the Plasmodium falciparum parasite provides important information about the local epidemiology of malaria. In this study, we examined the genetic diversity of P. falciparum isolates from the Artibonite Valley in Haiti using the allelic families of merozoite surface protein 1 and 2 genes (msp-1 and msp-2). The majority of study subjects infected with P. falciparum had a single parasite genotype (56% for msp-1 and 69% for msp-2: n=79); 9 distinct msp-1 genotypes were identified by size differences on agarose gels. K1 was the most polymorphic allelic family with 5 genotypes (amplicons from 100 to 300 base pairs [bp]); RO33 was the least polymorphic, with a single genotype (120-bp). Although both msp-2 alleles (3D7/IC1, FC27) had similar number of genotypes (n=4), 3D7/IC1 was more frequent (85% vs. 26%). All samples were screened for the presence of the K76T mutation on the P. falciparum chloroquine resistance transporter (pfcrt) gene with 10 of 79 samples positive. Of the 2 (out of 10) samples from individuals follow-up for 21 days, P. falciparum parasites were present through day 7 after treatment with chloroquine. No parasites were found on day 21. Our results suggest that the level of genetic diversity is low in this area of Haiti, which is consistent with an area of low transmission. Copyright © 2011 Elsevier B.V. All rights reserved.

Complex rupture during the 12 January 2010 Haiti earthquake

USGS Publications Warehouse

Hayes, G.P.; Briggs, R.W.; Sladen, A.; Fielding, E.J.; Prentice, C.; Hudnut, K.; Mann, P.; Taylor, F.W.; Crone, A.J.; Gold, R.; Ito, T.; Simons, M.

2010-01-01

Initially, the devastating Mw 7.0, 12 January 2010 Haiti earthquake seemed to involve straightforward accommodation of oblique relative motion between the Caribbean and North American plates along the Enriquillog-Plantain Garden fault zone. Here, we combine seismological observations, geologic field data and space geodetic measurements to show that, instead, the rupture process may have involved slip on multiple faults. Primary surface deformation was driven by rupture on blind thrust faults with only minor, deep, lateral slip along or near the main Enriquillog-Plantain Garden fault zone; thus the event only partially relieved centuries of accumulated left-lateral strain on a small part of the plate-boundary system. Together with the predominance of shallow off-fault thrusting, the lack of surface deformation implies that remaining shallow shear strain will be released in future surface-rupturing earthquakes on the Enriquillog-Plantain Garden fault zone, as occurred in inferred Holocene and probable historic events. We suggest that the geological signature of this earthquakeg-broad warping and coastal deformation rather than surface rupture along the main fault zoneg-will not be easily recognized by standard palaeoseismic studies. We conclude that similarly complex earthquakes in tectonic environments that accommodate both translation and convergenceg-such as the San Andreas fault through the Transverse Ranges of Californiag-may be missing from the prehistoric earthquake record. ?? 2010 Macmillan Publishers Limited. All rights reserved.

Seroprevalence of Herpes Simplex Virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti.

PubMed

Domercant, Jean Wysler; Jean Louis, Frantz; Hulland, Erin; Griswold, Mark; Andre-Alboth, Jocelyne; Ye, Tun; Marston, Barbara J

2017-08-18

Herpes simplex virus type 2 (HSV-2), one the most common causes of genital ulcers, appears to increase both the risk of HIV acquisition and HIV transmission. HSV-2/HIV co-infection among pregnant women may increase the risk of perinatal transmission of HIV. This study describes rates of HSV-2 among pregnant women in Haiti and HSV-2 test performance in this population. Unlinked residual serum specimens from the 2012 National HIV and Syphilis Sentinel Surveillance Survey among pregnant women in Haiti were tested using two commercial kits (Focus HerpeSelect, Kalon) for HSV-2 antibodies. We evaluated rates of HSV-2 seropositivity and HSV-2/HIV co-infection, associations between HSV-2 and demographic characteristics using multivariable Cox proportional hazards modeling, and HSV-2 test performance in this population. Serum samples from 1000 pregnant women (all 164 HIV positive and 836 random HIV negative) were selected. The overall weighted prevalence of HSV-2 was 31.4% (95% CI: 27.7-35.4) and the prevalence of HIV-positivity among HSV-2 positive pregnant women was five times higher than the prevalence among HSV-2 negative women (4.8% [95% CI: 3.9-6.0] vs. 0.9% [95% CI: 0.6-1.3], respectively). Factors significantly associated with HSV-2 positivity were HIV-positivity (PR: 2.27 [95% CI: 1.94-2.65]) and older age (PRs: 1.41 [95% CI: 1.05-1.91] for 20-24 years, 1.71 [95% CI:1.13-2.60] for 30-34 years, and 1.55 [95% CI: 1.10-2.19] for 35 years or greater]), while rural residence was negatively associated with HSV-2 positivity (PR 0.83 [95% CI: 0.69-1.00]), after controlling for other covariables. For this study a conservative Focus index cutoff of 3.5 was used, but among samples with a Focus index value ≥2.5, 98.4% had positive Kalon tests. The prevalence of HSV-2 is relatively high among pregnant women in Haiti. Public health interventions to increase access to HSV-2 screening in antenatal services are warranted.

Fifteen years of PMTCT HIV and Syphilis outcomes in Haiti from monotherapy to Option B.

PubMed

Deschamps, Marie Marcelle; Jannat-Khah, Deanna; Rouzier, Vanessa; Bonhomme, Jerry; Pierrot, Julma; Lee, Myung Hee; Abrams, Elaine; Pape, Jean; McNairy, Margaret L

2018-05-19

To evaluate mother and infant outcomes in the largest prevention of mother-to-child-transmission (PMTCT) program in Haiti in order to identify gaps towards elimination of HIV and syphilis. Based on retrospective data from HIV+ pregnant women and their infants enrolled in PMTCT care from 1999-2014, we assessed maternal enrolment in PMTCT, receipt of antiretrovirals before delivery, maternal retention through delivery, as well as infant enrolment in PMTCT, HIV testing, and HIV infection. 4 PMTCT program periods were compared: period 1 (1999-2004, mono ARV), period 2 (2005-2009, dual ARV), period 3 (2010-2012, Option B), and period 4 (Oct 2012-2014, Option B+). Kaplan Meier methods were used to assess retention in PMTCT care. Among 4,665 pregnancies, median age was 27 years and median CD4+ was 494 cells/uL (IQR 328-691). 75% of women received antiretrovirals before delivery and 73% were retained in care through delivery. 22% were lost before delivery, <1% died, and 6% had stillbirths or abortions. 94% of infants born alive enrolled in PMTCT, of whom 92% had complete HIV testing. 161 infants were HIV+, giving a 5.4% HIV transmission rate (9.8%, 4.6%, 5.8%, and 3.6% in periods 1-4). Retention among women through 12 months after PMTCT enrolment did not significantly differ across periods. However, among women who received antiretrovirals at the time of enrolment, retention 12 months later was lower in the Option B+ period (83%) than in periods 2 and 3 (94% and 93%) (p<0.001). Syphilis infection decreased from 16% in period 1 to 8% in period 4, whereas syphilis testing of infants increased from 17% to 91%. Despite dramatic reductions in MTCT in Haiti, interventions are needed to improve retention to achieve MTCT elimination of HIV and syphilis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Evaluation of Knowledge and Practices Regarding Cholera, Water Treatment, Hygiene, and Sanitation Before and After an Oral Cholera Vaccination Campaign-Haiti, 2013-2014.

PubMed

Childs, Lana; François, Jeannot; Choudhury, Alina; Wannemuehler, Kathleen; Dismer, Amber; Hyde, Terri B; Yen, Catherine Y; Date, Kashmira A; Juin, Stanley; Katz, Mark A; Kantor, Erica Felker; Routh, Janell; Etheart, Melissa; Wright, Tracie; Adrien, Paul; Tohme, Rania A

2016-12-07

In 2013, the Government of Haiti implemented its first oral cholera vaccine (OCV) campaign in Petite Anse, an urban setting, and Cerca Carvajal, a rural commune. We conducted and compared responses to two independent cross-sectional knowledge and practices household surveys pre- (N = 297) and post- (N = 302) OCV campaign in Petite Anse. No significant differences in knowledge about causes, symptoms, and prevention of cholera were noted. Compared with precampaign respondents, fewer postcampaign respondents reported treating (66% versus 27%, P < 0.001) and covering (96% versus 89%, P = 0.02) their drinking water. Compared with precampaign, postcampaign survey household observations showed increased availability of soap (16.2% versus 34.5%, P = 0.001) and handwashing stations (14.7% versus 30.1%, P = 0.01), but no significant changes in handwashing practices were reported. Although there was no change in knowledge, significant decreases in water treatment practices necessary for cholera and other diarrheal diseases prevention were noted in the postcampaign survey. Future OCV campaigns in Haiti should be used as an opportunity to emphasize the importance of maintaining good water, sanitation, and hygiene practices, and include a comprehensive, integrated approach for cholera control. © The American Society of Tropical Medicine and Hygiene.

Advancing Research Methods to Detect Impact of Climate Change on Health in Grand'Anse, Haiti

NASA Astrophysics Data System (ADS)

Barnhart, S.; Coq, R. N.; Frederic, R.; DeRiel, E.; Camara, H.; Barnhart, K. R.

2013-12-01

Haiti is considered particularly vulnerable to the effects of climate change, but directly linking climate change to health effects is limited by the lack of robust data and the multiple determinants of health. Worsening storms and rising temperatures in this rugged country with high poverty is likely to adversely affect economic activity, population growth and other determinants of health. For the past two years, the Univ. of Washington has supported the public hospital in the department of Grand'Anse. Grand'Anse, a relatively contained region in SW Haiti with an area of 11,912 km2, is predominantly rural with a population of 350,000 and is bounded to the south by peaks up to 2,347 m. Grand'Anse would serve as an excellent site to assess the interface between climate change and health. The Demographic and Health Survey (DHS) shows health status is low relative to other countries. Estimates of climate change for Jeremie, the largest city in Grand'Anse, predict the mean monthly temperature will increase from 26.1 to 27.3 oC while mean monthly rainfall will decrease from 80.5 to 73.5 mm over the next 60 years. The potential impact of these changes ranges from threatening food security to greater mortality. Use of available secondary data such as indicators of climate change and DHS health status are not likely to offer sufficient resolution to detect positive or negative impacts of climate change on health. How might a mixed methods approach incorporating secondary data and quantitative and qualitative survey data on climate, economic activity, health and determinants of health address the hypothesis: Climate change does not adversely affect health? For example, in Haiti most women deliver at home. Maternal mortality is high at 350 deaths/100,000 deliveries. This compares to deliveries in facilities where the median rate is less than 100/100,000. Thus, maternal mortality is closely linked to access to health care in this rugged mountainous country. Climate change

The influence of power on HIV risk among pregnant women in rural Haiti.

PubMed

Kershaw, Trace S; Small, Maria; Joseph, Gabriel; Theodore, Melanie; Bateau, Reginald; Frederic, Rikerdy

2006-05-01

Given that condom use is not directly under a woman's control, the sexual division of power may play an important role in sexual behavior among pregnant women. We assessed the influence of factors related to the theory of gender and power (e.g., relationship power, abuse history, and sexual communication) on sexual behavior (e.g., two or more partners in the year prior to pregnancy, condom use, condom-use intentions, and STI diagnosis) among 196 pregnant women recruited from five community dispensaries in rural Haiti. Results showed that gender and power factors significantly related to sexual behavior. Gender and power factors were most significant for condom use and intention to use condoms, accounting for 18 and 25% of the variance above and beyond HIV knowledge and demographic covariates, respectively. These results suggest the need to create prevention interventions that restore power imbalances, provide support for women suffering abuse, and strengthen communication skills.

Activity-based costing of health-care delivery, Haiti.

PubMed

McBain, Ryan K; Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient's medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated.

Cost-Effectiveness of Early Versus Standard Antiretroviral Therapy in HIV-Infected Adults in Haiti

PubMed Central

Koenig, Serena P.; Bang, Heejung; Severe, Patrice; Jean Juste, Marc Antoine; Ambroise, Alex; Edwards, Alison; Hippolyte, Jessica; Fitzgerald, Daniel W.; McGreevy, Jolion; Riviere, Cynthia; Marcelin, Serge; Secours, Rode; Johnson, Warren D.; Pape, Jean W.; Schackman, Bruce R.

2011-01-01

Background In a randomized clinical trial of early versus standard antiretroviral therapy (ART) in HIV-infected adults with a CD4 cell count between 200 and 350 cells/mm3 in Haiti, early ART decreased mortality by 75%. We assessed the cost-effectiveness of early versus standard ART in this trial. Methods and Findings Trial data included use of ART and other medications, laboratory tests, outpatient visits, radiographic studies, procedures, and hospital services. Medication, laboratory, radiograph, labor, and overhead costs were from the study clinic, and hospital and procedure costs were from local providers. We evaluated cost per year of life saved (YLS), including patient and caregiver costs, with a median of 21 months and maximum of 36 months of follow-up, and with costs and life expectancy discounted at 3% per annum. Between 2005 and 2008, 816 participants were enrolled and followed for a median of 21 months. Mean total costs per patient during the trial were US$1,381 for early ART and US$1,033 for standard ART. After excluding research-related laboratory tests without clinical benefit, costs were US$1,158 (early ART) and US$979 (standard ART). Early ART patients had higher mean costs for ART (US$398 versus US$81) but lower costs for non-ART medications, CD4 cell counts, clinically indicated tests, and radiographs (US$275 versus US$384). The cost-effectiveness ratio after a maximum of 3 years for early versus standard ART was US$3,975/YLS (95% CI US$2,129/YLS–US$9,979/YLS) including research-related tests, and US$2,050/YLS excluding research-related tests (95% CI US$722/YLS–US$5,537/YLS). Conclusions Initiating ART in HIV-infected adults with a CD4 cell count between 200 and 350 cells/mm3 in Haiti, consistent with World Health Organization advice, was cost-effective (US$/YLS <3 times gross domestic product per capita) after a maximum of 3 years, after excluding research-related laboratory tests. Trial registration ClinicalTrials.gov NCT00120510 Please see

Mental health response in Haiti in the aftermath of the 2010 earthquake: a case study for building long-term solutions.

PubMed

Raviola, Giuseppe; Eustache, Eddy; Oswald, Catherine; Belkin, Gary S

2012-01-01

Significant challenges exist in providing safe, effective, and culturally sound mental health and psychosocial services when an unforeseen disaster strikes in a low-resource setting. We present here a case study describing the experience of a transnational team in expanding mental health and psychosocial services delivered by two health care organizations, one local (Zanmi Lasante) and one international (Partners in Health), acting collaboratively as part of the emergency response to the 2010 Haiti earthquake. In the year and a half following the earthquake, Zanmi Lasante and Partners in Health provided 20,000 documented individual and group appointments for mental health and psychosocial needs. During the delivery of disaster response services, the collaboration led to the development of a model to guide the expansion and scaling up of community-based mental health services in the Zanmi Lasante health care system over the long-term, with potential for broader scale-up in Haiti. This model identifies key skill packages and implementation rules for developing evidence-based pathways and algorithms for treating common mental disorders. Throughout the collaboration, efforts were made to coordinate planning with multiple organizations interested in supporting the development of mental health programs following the disaster, including national governmental bodies, nongovernmental organizations, universities, foreign academic medical centers, and corporations. The collaborative interventions are framed here in terms of four overarching categories of action: direct service delivery, research, training, and advocacy. This case study exemplifies the role of psychiatrists working in low-resource settings as public health program implementers and as members of multidisciplinary teams.

The United Nations Material Assistance to Survivors of Cholera in Haiti: Consulting Survivors and Rebuilding Trust

PubMed Central

Pham, Phuong N; Gibbons, Niamh; Vinck, Patrick

2017-01-01

Introduction: In August 2016, the United Nations (U.N.) Secretary General acknowledged the U.N.’s role in the cholera epidemic that has beset Haiti since 2010. Two months later, the Secretary General issued a historic apology to the Haitian people before the U.N. General Assembly, for the organization’s insufficient response to the cholera outbreak. These steps are part of the U.N.’s “new approach” to cholera in Haiti, which also includes launching a material assistance package for those most affected by cholera. Methods: This paper draws on the authors’ experience and findings from consultations with more than 60,000 victims and communities affected by disasters and violence in a dozen countries. We reviewed the literature on best practices for consultation with and outreach to communities affected by development and transitional justice programming, and reviewed our own findings from previous studies with a view to identifying recommendations for ensuring that the assistance package reflects the views of people affected by cholera. Results: The assistance package program is an opportunity to rebuild the relationship between the victims and the United Nations. This can only be achieved if victims are informed and engaged in the process. This consultation effort is also an opportunity to answer a set of key questions related to the nature, structure, and implementation of the victims’ assistance program, but also how the program may be designed to contribute to rebuilding Haitians’ confidence in the U.N. as an institution that promotes peace, human rights, and development. Discussion: We recommend that the consultations must be accompanied by an outreach effort that provides clear, accurate information on the assistance program, so that it begins to establish a dialogue between the U.N. and cholera victims. Finally, we conclude by offering a number of concrete next steps that the U.N. can take to kick start the consultation process. PMID:29188126

Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination

PubMed Central

Tohme, Rania A.; François, Jeannot; Wannemuehler, Kathleen; Magloire, Roc; Danovaro-Holliday, M. Carolina; Flannery, Brendan; Cavallaro, Kathleen F.; Fitter, David L.; Purcell, Nora; Dismer, Amber; Tappero, Jordan W.; Vertefeuille, John F.; Hyde, Terri B.

2015-01-01

Objectives We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1–9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA). Methods Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster. Results Among the 7000 visited households, 75.8% had at least one child aged 1–9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1–4 years had significantly lower MR SIA coverage than those aged 5–9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8–9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001). Conclusions The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1–4 years and in regions with lower coverage. PMID:25041586

Field Trial of the CareStart Biosensor Analyzer for the Determination of Glucose-6-Phosphate Dehydrogenase Activity in Haiti.

PubMed

Weppelmann, Thomas A; von Fricken, Michael E; Wilfong, Tara D; Aguenza, Elisa; Philippe, Taina T; Okech, Bernard A

2017-10-01

Throughout many developing and tropical countries around the world, malaria remains a significant threat to human health. One barrier to malaria elimination is the ability to safely administer primaquine chemotherapy for the radical cure of malaria infections in populations with a high prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency. In the current study, a field trial of the world's first quantitative, point-of-care assay for measuring G6PD activity was conducted in Haiti. The performance of the CareStart Biosensor Analyzer was compared with the gold standard spectrophotometric assay and genotyping of the G6PD allele in schoolchildren ( N = 343) from the Ouest Department of Haiti. In this population, 19.5% of participants (67/343) had some form of G6PD deficiency (< 60% residual activity) and 9.9% (34/343) had moderate-to-severe G6PD deficiency (< 30% residual activity). Overall, 18.95% of participants had the presence of the A-allele (65/343) with 7.87% (27/343) considered at high risk for drug-induced hemolysis (hemizygous males and homozygous females). Compared with the spectrophotometric assay, the sensitivity and specificity to determine participants with < 60% residual activity were 53.7% and 94.6%, respectively; for participants with 30% residual activity, the sensitivity and specificity were 5.9% and 99.7%, respectively. The biosensor overestimated the activity in deficient individuals and underestimated it in participants with normal G6PD activity, indicating the potential for a systematic measurement error. Thus, we suggest that the current version of the biosensor lacks adequate sensitivity and should be improved prior to its use as a point-of-care diagnostic for G6PD deficiency.

Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination.

PubMed

Tohme, Rania A; François, Jeannot; Wannemuehler, Kathleen; Magloire, Roc; Danovaro-Holliday, M Carolina; Flannery, Brendan; Cavallaro, Kathleen F; Fitter, David L; Purcell, Nora; Dismer, Amber; Tappero, Jordan W; Vertefeuille, John F; Hyde, Terri B

2014-09-01

We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1-9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA). Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster. Among the 7000 visited households, 75.8% had at least one child aged 1-9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1-4 years had significantly lower MR SIA coverage than those aged 5-9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8-9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001). The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1-4 years and in regions with lower coverage. © 2014 John Wiley & Sons Ltd.

Impact of community-delivered SMS alerts on dog-owner participation during a mass rabies vaccination campaign, Haiti 2017.

PubMed

Cleaton, Julie M; Wallace, Ryan M; Crowdis, Kelly; Gibson, Andy; Monroe, Benjamin; Ludder, Fleurinord; Etheart, Melissa D; Natal Vigilato, Marco Antonio; King, Alasdair

2018-04-19

Haiti has historically vaccinated between 100,000 and 300,000 dogs annually against rabies, however national authorities have not been able to reach and maintain the 70% coverage required to eliminate the canine rabies virus variant. Haiti conducts massive dog vaccination campaigns on an annual basis and utilizes both central point and door-to-door methods. These methods require that dog owners are aware of the dates and locations of the campaign. To improve this awareness among dog owners, 600,000 text messages were sent to phones in two Haitian communes (Gonaives and Saint-Marc) to remind dog owners to attend the campaign. Text messages were delivered on the second day and at the mid-point of the campaign. A post-campaign household survey was conducted to assess dog owner's perception of the text messages and the impact on their participation in the vaccination campaign. Overall, 147 of 160 (91.9%) text-receiving dog owners indicated the text was helpful, and 162 of 187 (86.6%) responding dog owners said they would like to receive text reminders during future rabies vaccination campaigns. In areas hosting one-day central point campaigns, dog owners who received the text were 2.0 (95% CI 1.1, 3.6) times more likely to have participated in the campaign (73.1% attendance among those who received the text vs 36.4% among those who did not). In areas incorporating door-to-door vaccination over multiple days there was no significant difference in participation between dog owners who did and did not receive a text. Text message reminders were well-received and significantly improved campaign attendance, indicating that short message service (SMS) alerts may be a successful strategy in low resource areas with large free roaming dog populations. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Occurrence of Toxigenic Fungi and Aflatoxin Potential of Aspergillus spp. Strains Associated with Subsistence Farmed Crops in Haiti.

PubMed

Aristil, Junior; Venturini, Giovanni; Spada, Alberto

2017-04-01

Subsistence farming and poor storage facilities favor toxigenic fungal contamination and mycotoxin accumulation in staple foods from tropical countries such as Haiti. The present preliminary study was designed to evaluate the occurrence of toxigenic fungi in Haitian foodstuffs to define the mycotoxin risk associated with Haitian crops. The objectives of this research were to determine the distribution of toxigenic fungi in the Haitian crops maize, moringa, and peanut seeds and to screen Aspergillus section Flavi (ASF) isolates for production of aflatoxins B 1 and G 1 in vitro. Maize, moringa, and peanut samples were contaminated by potential toxigenic fungal taxa, mainly ASF and Fusarium spp. The isolation frequency of Aspergillus spp. and Fusarium spp. was influenced by locality and thus by farming systems, storage systems, and weather conditions. Particularly for ASF in peanut and maize samples, isolation frequencies were directly related to the growing season length. The present study represents the first report of contamination by toxigenic fungi and aflatoxin in moringa seeds, posing concerns about the safety of these seeds, which people in Haiti commonly consume. Most (80%) of the Haitian ASF strains were capable of producing aflatoxins, indicating that Haitian conditions clearly favor the colonization of toxigenic ASF strains over atoxigenic strains. ASF strains producing both aflatoxins B 1 and G 1 were found. Understanding the distribution of toxigenic ASF in Haitian crops and foodstuffs is important for determining accurate toxicological risks because the toxic profile of ASF is species specific. The occurrence of toxigenic fungi and the profiles of the ASF found in various crops highlight the need to prevent formation of aflatoxins in Haitian crops. This study provides relevant preliminary baseline data for guiding the development of legislation regulating the quality and safety of crops in this low-income country.

Ethical Considerations of Triage Following Natural Disasters: The IDF Experience in Haiti as a Case Study.

PubMed

Ram-Tiktin, Efrat

2017-07-01

Natural disasters in populated areas may result in massive casualties and extensive destruction of infrastructure. Humanitarian aid delegations may have to cope with the complicated issue of patient prioritization under conditions of severe resource scarcity. A triage model, consisting of five principles, is proposed for the prioritization of patients, and it is argued that rational and reasonable agents would agree upon them. The Israel Defense Force's humanitarian mission to Haiti following the 2010 earthquake serves as a case study for the various considerations taken into account when designing the ethical-clinical policy of field hospitals. The discussion focuses on three applications: the decision to include an intensive care unit, the decision to include obstetrics and neonatal units, and the treatment policy for compound fractures. © 2017 John Wiley & Sons Ltd.

Activity-based costing of health-care delivery, Haiti

PubMed Central

Jerome, Gregory; Leandre, Fernet; Browning, Micaela; Warsh, Jonathan; Shah, Mahek; Mistry, Bipin; Faure, Peterson Abnis I; Pierre, Claire; Fang, Anna P; Mugunga, Jean Claude; Gottlieb, Gary; Rhatigan, Joseph; Kaplan, Robert

2018-01-01

Abstract Objective To evaluate the implementation of a time-driven activity-based costing analysis at five community health facilities in Haiti. Methods Together with stakeholders, the project team decided that health-care providers should enter start and end times of the patient encounter in every fifth patient’s medical dossier. We trained one data collector per facility, who manually entered the time recordings and patient characteristics in a database and submitted the data to a cloud-based data warehouse each week. We calculated the capacity cost per minute for each resource used. An automated web-based platform multiplied reported time with capacity cost rate and provided the information to health-facilities administrators. Findings Between March 2014 and June 2015, the project tracked the clinical services for 7162 outpatients. The cost of care for specific conditions varied widely across the five facilities, due to heterogeneity in staffing and resources. For example, the average cost of a first antenatal-care visit ranged from 6.87 United States dollars (US$) at a low-level facility to US$ 25.06 at a high-level facility. Within facilities, we observed similarly variation in costs, due to factors such as patient comorbidities, patient arrival time, stocking of supplies at facilities and type of visit. Conclusion Time-driven activity-based costing can be implemented in low-resource settings to guide resource allocation decisions. However, the extent to which this information will drive observable changes at patient, provider and institutional levels depends on several contextual factors, including budget constraints, management, policies and the political economy in which the health system is situated. PMID:29403096

K/T spherules from Haiti and Wyoming: Origin, diagenesis, and similarity to some microtektites

NASA Technical Reports Server (NTRS)

Bohor, B. F.; Glass, B. P.; Betterton, W. J.

1993-01-01

Spherules with relict glass cores in the K/T boundary bed of Haiti allow for a comparison of these bodies with hollow goyazite shells in the K/T boundary claystone of Wyoming and with younger microtektites of the Ivory Coast strewn field. Samples of the Haitian beds from undisturbed sections at Beloc, as determined by Jehanno et al., contain both hollow shells and relict glass cores rimmed by palagonite that has been partially converted to smectite. These palagonite rims developed from hydration zones formed when hot, splash-form droplets of andesitic impact glass were deposited into water. Mutual collisions between these droplets in the ejecta curtain may have formed point-source stresses on their surfaces. Initiation of hydration would be facilitated at these surface stress points and propagated radially into the glass. The inner surface of these merged hemispherical fronts appears mammillary, which is reflected as scalloping in Haitian relict glass cores.

Oral Cholera Vaccine Coverage, Barriers to Vaccination, and Adverse Events following Vaccination, Haiti, 2013.

PubMed

Tohme, Rania A; François, Jeannot; Wannemuehler, Kathleen; Iyengar, Preetha; Dismer, Amber; Adrien, Paul; Hyde, Terri B; Marston, Barbara J; Date, Kashmira; Mintz, Eric; Katz, Mark A

2015-06-01

In 2013, the first government-led oral cholera vaccination (OCV) campaign in Haiti was implemented in Petite Anse and Cerca Carvajal. To evaluate vaccination coverage, barriers to vaccination, and adverse events following vaccination, we conducted a cluster survey. We enrolled 1,121 persons from Petite Anse and 809 persons from Cerca Carvajal, categorized by 3 age groups (1-4, 5-14, >15 years). Two-dose OCV coverage was 62.5% in Petite Anse and 76.8% in Cerca Carvajal. Two-dose coverage was lowest among persons >15 years of age. In Cerca Carvajal, coverage was significantly lower for male than female respondents (69% vs. 85%; p<0.001). No major adverse events were reported. The main reason for nonvaccination was absence during the campaign. Vaccination coverage after this campaign was acceptable and comparable to that resulting from campaigns implemented by nongovernmental organizations. Future campaigns should be tailored to reach adults who are not available during daytime hours.

Strengthening National Disease Surveillance and Response—Haiti, 2010–2015

PubMed Central

Juin, Stanley; Schaad, Nicolas; Lafontant, Donald; Joseph, Gerard A.; Barzilay, Ezra; Boncy, Jacques; Barrais, Robert; Louis, Frantz Jean; Jean Charles, Nadia Lapierre; Corvil, Salomon; Barthelemy, Nickolsno; Dismer, Amber; Pierre, Jean Samuel; Archer, Roodly W.; Antoine, Mayer; Marston, Barbara; Katz, Mark; Dely, Patrick; Adrien, Paul; Fitter, David L.; Lowrance, David; Patel, Roopal

2017-01-01

Abstract. Haiti’s health system has faced many challenges over the years, with competing health priorities in the context of chronic financial and human resource limitations. As a result, the existing notifiable disease surveillance system was unable to provide the most basic epidemiologic data for public health decision-making and action. In the wake of the January 2010 earthquake, the Haitian Ministry of Public Health and Population collaborated with the U.S. Centers for Disease Control and Prevention, the Pan American Health Organization, and other local and international partners to implement a functional national surveillance system. More than 7 years later, it is important to take the opportunity to reflect on progress made on surveillance and response in Haiti, including disease detection, reporting, outbreak investigation, and response. The national epidemiologic surveillance network that started with 51 sites in 2010 has been expanded to 357 sites as of December 2015. Disease outbreaks identified via the surveillance system, or other surveillance approaches, are investigated by epidemiologists trained by the Ministry of Health’s Field Epidemiology Training Program. Other related surveillance modules have been developed on the same model and electronic platform, allowing the country to document the impact of interventions, track progress, and monitor health problems. Sustainability remains the greatest challenge since most of the funding for surveillance come from external sources. PMID:29064361

Emotions and beliefs after a disaster: a comparative analysis of Haiti and Indonesia.

PubMed

O'Connell, Erin; Abbott, Roger P; White, Robert S

2017-10-01

A number of studies have examined emotional and belief responses following a disaster, yet there has been limited comparative analysis of responses to disasters in different places. This paper reviews the results of 366 questionnaires that evaluated key emotional and belief concepts in Haiti after the earthquake on 12 January 2010 (n=212) and in Indonesia after the earthquake in Yogyakarta on 27 May 2006 (n=154). The results indicate significant differences between the responses in the two settings, particularly in relation to feelings of impunity, self-blame for the disaster, regret about pre-earthquake behaviour, and a sense of justice in the world. Furthermore, the impacts of age, education, and gender on responses also were different in the two case study sites. Overall, the results suggest that understanding the cultural, religious, and social contexts of different disaster locales is important in comprehending the emotions and beliefs that manifest themselves in the wake of a major disaster. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Need for certification of household water treatment products: examples from Haiti.

PubMed

Murray, Anna; Pierre-Louis, Jocelyne; Joseph, Flaurine; Sylvain, Ginelove; Patrick, Molly; Lantagne, Daniele

2015-04-01

To evaluate four household water treatment (HWT) products currently seeking approval for distribution in Haiti, through the application of a recently-developed national HWT product certification process. Four chemical treatment products were evaluated against the certification process validation stage by verifying international product certifications confirming treatment efficacy and reviewing laboratory efficacy data against WHO HWT microbiological performance targets; and against the approval stage by confirming product composition, evaluating treated water chemical content against national and international drinking water quality guidelines and reviewing packaging for dosing ability and usage directions in Creole. None of the four evaluated products fulfilled validation or approval stage requirements. None was certified by an international agency as efficacious for drinking water treatment, and none had data demonstrating its ability to meet WHO HWT performance targets. All product sample compositions differed from labelled composition by >20%, and no packaging included complete usage directions in Creole. Product manufacturers provided information that was inapplicable, did not demonstrate product efficacy, and was insufficient to ensure safe product use. Capacity building is needed with country regulatory agencies to objectively evaluate HWT products. Products should be internationally assessed against WHO performance targets and also locally approved, considering language, culture and usability, to ensure effective HWT. © 2014 John Wiley & Sons Ltd.

Need for certification of household water treatment products: examples from Haiti

PubMed Central

Murray, Anna; Pierre-Louis, Jocelyne; Joseph, Flaurine; Sylvain, Ginelove; Patrick, Molly; Lantagne, Daniele

2015-01-01

OBJECTIVE To evaluate four household water treatment (HWT) products currently seeking approval for distribution in Haiti, through the application of a recently-developed national HWT product certification process. METHODS Four chemical treatment products were evaluated against the certification process validation stage by verifying international product certifications confirming treatment efficacy and reviewing laboratory efficacy data against WHO HWT microbiological performance targets; and against the approval stage by confirming product composition, evaluating treated water chemical content against national and international drinking water quality guidelines and reviewing packaging for dosing ability and usage directions in Creole. RESULTS None of the four evaluated products fulfilled validation or approval stage requirements. None was certified by an international agency as efficacious for drinking water treatment, and none had data demonstrating its ability to meet WHO HWT performance targets. All product sample compositions differed from labelled composition by >20%, and no packaging included complete usage directions in Creole. CONCLUSIONS Product manufacturers provided information that was inapplicable, did not demonstrate product efficacy, and was insufficient to ensure safe product use. Capacity building is needed with country regulatory agencies to objectively evaluate HWT products. Products should be internationally assessed against WHO performance targets and also locally approved, considering language, culture and usability, to ensure effective HWT. PMID:25441711

Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti.

PubMed

Donegan, Shannon; Maluccio, John A; Myers, Caitlin K; Menon, Purnima; Ruel, Marie T; Habicht, Jean-Pierre

2010-06-01

Rigorous evaluations of food-assisted maternal and child health and nutrition programs are stymied by the ethics of randomizing recipients to a control treatment. Using nonexperimental matching methods, we evaluated the effect of 2 such programs on child linear growth in Haiti. The 2 well-implemented programs offered the same services (food assistance, behavior change communication, and preventive health services) to pregnant and lactating women and young children. They differed in that one (the preventive program) used blanket targeting of all children 6-23 mo, whereas the other (the recuperative program) targeted underweight (weight-for-age Z score < -2) children 6-59 mo, as traditionally done. We estimated program effects on height-for-age Z scores (HAZ) and stunting (HAZ < -2) by comparing outcomes of children in program areas with matched children from comparable populations in the Haiti Demographic and Health Survey. Children 12-41 mo in the preventive and recuperative program areas had lower prevalence of stunting than those in the matched control group [16 percentage points (pp) lower in preventive and 11 pp in recuperative]. Children in the 2 program areas also were more likely than those in the matched control group to be breast-fed up to 24 mo (25 pp higher in preventive, 22 in recuperative) and children 12 mo and older were more likely to have received the recommended full schedule of vaccinations (32 pp higher in preventive, 31 in recuperative). Both programs improved targeted behaviors and protected child growth in a time of deteriorating economic circumstances.

Ethical questions identified in a study of local and expatriate responders' perspectives of vulnerability in the 2010 Haiti earthquake.

PubMed

Durocher, Evelyne; Chung, Ryoa; Rochon, Christiane; Henrys, Jean-Hugues; Olivier, Catherine; Hunt, Matthew

2017-09-01

Situations of disaster that prompt international humanitarian responses are rife with ethical tensions. The 2010 Haiti earthquake caused great destruction and prompted a massive humanitarian response. The widespread needs experienced by the population and the scale of the response inevitably rendered priority-setting difficult, and gave rise to ethical challenges. This paper presents four ethical questions identified in the analysis of a study on vulnerability and equity in the humanitarian response to the 2010 Haiti earthquake. Using interpretive description methodology, the interdisciplinary research team analysed 24 semi-structured in-depth interviews conducted with expatriate and Haitian health workers and decision-makers involved in the response. Ethical questions identified through the analysis were: (1) How should limited resources be allocated in situations of widespread vulnerability and elevated needs? (2) At what point does it become ethically problematic to expend (considerable) resources to sustain expatriate disaster responders? (3) How ought rapid and reactive interventions be balanced with more deliberated and coordinated approaches? (4) What trade-offs are justified when interventions to address acute needs could contribute to long-term vulnerabilities? The questions arise in light of an immense gap between available resources and widespread and elevated needs. This gap is likely unavoidable in large-scale crises and may be a source of ethical distress for both local and international responders. The analysis of ethical questions associated with crisis response can advance discussions about how relief efforts can best be designed and implemented to minimise ethical distress and improve assistance to local populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An Exploratory Study of Acculturation and Reproductive Health Among Haitian and Haitian-American Women in Little Haiti, South Florida.

PubMed

Cyrus, E; Gollub, E L; Jean-Gilles, M; Neptune, S; Pelletier, V; Dévieux, J

2016-06-01

There is unmet contraceptive need among Haitian immigrants and Haitian-American women (Haitian women). The study explored associations of three measures of acculturation with contraceptive/reproductive health history among Haitian women residing in the Little Haiti community of Miami. This was a cross-sectional, exploratory study among 57 Haitian women. We conducted descriptive univariate analyses, then bivariate analyses to investigate the association of acculturation with reproductive health risk behavior including contraceptive use, tampon use, and parity, as well as interest in a female-initiated barrier contraceptive method. The most commonly ever-used contraceptive methods were male condoms (78.9 %) and oral contraceptives (OC 19.3 %). Women who primarily spoke Créole at home were less likely than those who did not to use OC (11.9 vs. 42.9 %, p = .01). Among women who resided in the U.S. ≥10 years, tampon use was 51.9 % compared to 16.7 % among those who were in the U.S. for less time (p = .005). Among U.S. born women, 60 % were tampon users compared to 22.7 % among those born in Haiti (p = .05). Women not speaking primarily Créole at home (p = .06) and those born in U.S. (p = .008) had fewer children. Contraceptive use was low among Haitian women but influenced by acculturation, where greater acculturation was associated with protective reproductive health behavior. Despite traditional norms discouraging contraceptive use, and little experience with female barriers, Haitian women indicated an interest in learning about and using a female-initiated barrier contraceptive. Increasing contraceptive uptake of potential multipurpose technologies is a potential point of intervention for decreasing HIV/STI transmission in this at-risk population.

The effect of complex fault rupture on the distribution of landslides triggered by the 12 January 2010, Haiti earthquake

USGS Publications Warehouse

Harp, Edwin L.; Jibson, Randall W.; Dart, Richard L.; Margottini, Claudio; Canuti, Paolo; Sassa, Kyoji

2013-01-01

The MW 7.0, 12 January 2010, Haiti earthquake triggered more than 7,000 landslides in the mountainous terrain south of Port-au-Prince over an area that extends approximately 50 km to the east and west from the epicenter and to the southern coast. Most of the triggered landslides were rock and soil slides from 25°–65° slopes within heavily fractured limestone and deeply weathered basalt and basaltic breccia. Landslide volumes ranged from tens of cubic meters to several thousand cubic meters. Rock slides in limestone typically were 2–5 m thick; slides within soils and weathered basalt typically were less than 1 m thick. Twenty to thirty larger landslides having volumes greater than 10,000 m3 were triggered by the earthquake; these included block slides and rotational slumps in limestone bedrock. Only a few landslides larger than 5,000 m3 occurred in the weathered basalt. The distribution of landslides is asymmetric with respect to the fault source and epicenter. Relatively few landslides were triggered north of the fault source on the hanging wall. The densest landslide concentrations lie south of the fault source and the Enriquillo-Plantain-Garden fault zone on the footwall. Numerous landslides also occurred along the south coast west of Jacmél. This asymmetric distribution of landsliding with respect to the fault source is unusual given the modeled displacement of the fault source as mainly thrust motion to the south on a plane dipping to the north at approximately 55°; landslide concentrations in other documented thrust earthquakes generally have been greatest on the hanging wall. This apparent inconsistency of the landslide distribution with respect to the fault model remains poorly understood given the lack of any strong-motion instruments within Haiti during the earthquake.

Spatial-Temporal Analysis of Openstreetmap Data after Natural Disasters: a Case Study of Haiti Under Hurricane Matthew

NASA Astrophysics Data System (ADS)

Xu, J.; Li, L.; Zhou, Q.

2017-09-01

Volunteered geographic information (VGI) has been widely adopted as an alternative for authoritative geographic information in disaster management considering its up-to-date data. OpenStreetMap, in particular, is now aiming at crisis mapping for humanitarian purpose. This paper illustrated that natural disaster played an essential role in updating OpenStreetMap data after Haiti was hit by Hurricane Matthew in October, 2016. Spatial-temporal analysis of updated OSM data was conducted in this paper. Correlation of features was also studied to figure out whether updates of data were coincidence or the results of the hurricane. Spatial pattern matched the damaged areas and temporal changes fitted the time when disaster occurred. High level of correlation values of features were recorded when hurricane occurred, suggesting that updates in data were led by the hurricane.

Implementation and evaluation of a web based system for pharmacy stock management in rural Haiti.

PubMed

Berger, Elisabeth J; Jazayeri, Darius; Sauveur, Marcel; Manasse, Jean Joel; Plancher, Inel; Fiefe, Marquise; Laurat, Guerline; Joseph, Samahel; Kempton, Kathryn; Fraser, Hamish S F

2007-10-11

Managing the stock and supply of medication is essential for the provision of health care, especially in resource poor areas of the world. We have developed an innovative, web-based stock management system to support nine clinics in rural Haiti. Building on our experience with a web-based EMR system for our HIV patients, we developed a comprehensive stock tracking system that is modeled on the appearance of standardized WHO stock cards. The system allows pharmacy staff at all clinics to enter stock levels and also to request drugs and track shipments. Use of the system over the last 2 years has increased rapidly and we now track 450 products supporting care for 1.78 million patient visits annually. Over the last year drug stockouts have fallen from 2.6% to 1.1% and 97% of stock requests delivered were shipped within 1 day. We are now setting up this system in our clinics in rural Rwanda.

Predictors of disease severity in patients admitted to a cholera treatment center in urban Haiti.

PubMed

Valcin, Claude-Lyne; Severe, Karine; Riche, Claudia T; Anglade, Benedict S; Moise, Colette Guiteau; Woodworth, Michael; Charles, Macarthur; Li, Zhongze; Joseph, Patrice; Pape, Jean W; Wright, Peter F

2013-10-01

Cholera, previously unrecognized in Haiti, spread through the country in the fall of 2010. An analysis was performed to understand the epidemiological characteristics, clinical management, and risk factors for disease severity in a population seen at the GHESKIO Cholera Treatment Center in Port-au-Prince. A comprehensive review of the medical records of patients admitted during the period of October 28, 2010-July 10, 2011 was conducted. Disease severity on admission was directly correlated with older age, more prolonged length of stay, and presentation during the two epidemic waves seen in the observation period. Although there was a high seroprevalence of human immunodeficiency virus (HIV), severity of cholera was not greater with HIV infection. This study documents the correlation of cholera waves with rainfall and its reduction in settings with improved sanitary conditions and potable water when newly introduced cholera affects all ages equally so that interventions must be directed throughout the population.

Backward Bifurcation in a Cholera Model: A Case Study of Outbreak in Zimbabwe and Haiti

NASA Astrophysics Data System (ADS)

Sharma, Sandeep; Kumari, Nitu

In this paper, a nonlinear deterministic model is proposed with a saturated treatment function. The expression of the basic reproduction number for the proposed model was obtained. The global dynamics of the proposed model was studied using the basic reproduction number and theory of dynamical systems. It is observed that proposed model exhibits backward bifurcation as multiple endemic equilibrium points exist when R0 < 1. The existence of backward bifurcation implies that making R0 < 1 is not enough for disease eradication. This, in turn, makes it difficult to control the spread of cholera in the community. We also obtain a unique endemic equilibria when R0 > 1. The global stability of unique endemic equilibria is performed using the geometric approach. An extensive numerical study is performed to support our analytical results. Finally, we investigate two major cholera outbreaks, Zimbabwe (2008-09) and Haiti (2010), with the help of the present study.

Considerations for Oral Cholera Vaccine Use during Outbreak after Earthquake in Haiti, 2010−2011

PubMed Central

Vicari, Andrea; Hyde, Terri B.; Mintz, Eric; Danovaro-Holliday, M. Carolina; Henry, Ariel; Tappero, Jordan W.; Roels, Thierry H.; Abrams, Joseph; Burkholder, Brenton T.; Ruiz-Matus, Cuauhtémoc; Andrus, Jon; Dietz, Vance

2011-01-01

Oral cholera vaccines (OCVs) have been recommended in cholera-endemic settings and preemptively during outbreaks and complex emergencies. However, experience and guidelines for reactive use after an outbreak has started are limited. In 2010, after over a century without epidemic cholera, an outbreak was reported in Haiti after an earthquake. As intensive nonvaccine cholera control measures were initiated, the feasibility of OCV use was considered. We reviewed OCV characteristics and recommendations for their use and assessed global vaccine availability and capacity to implement a vaccination campaign. Real-time modeling was conducted to estimate vaccine impact. Ultimately, cholera vaccination was not implemented because of limited vaccine availability, complex logistical and operational challenges of a multidose regimen, and obstacles to conducting a campaign in a setting with population displacement and civil unrest. Use of OCVs is an option for cholera control; guidelines for their appropriate use in epidemic and emergency settings are urgently needed. PMID:22099114

Source rupture process of the 12 January 2010 Port-au-Prince (Haiti, Mw7.0) earthquake

NASA Astrophysics Data System (ADS)

Borges, José; Caldeira, Bento; Bezzeghoud, Mourad; Santos, Rúben

2010-05-01

The Haiti earthquake occurred on tuesday, January 12, 2010 at 21:53:10 UTC. Its epicenter was at 18.46 degrees North, 72.53 degrees West, about 25 km WSW of Haiti's capital, Port-au-Prince. The earthquake was relatively shallow (H=13 km, U.S. Geological Survey) and thus had greater intensity and destructiveness. The earthquake occurred along the tectonic boundary between Caribbean and North America plate. This plate boundary is dominated by left-lateral strike slip motion and compression with 2 cm/year of slip velocity eastward with respect to the North America plate. The moment magnitude was measured to be 7.0 (U.S. Geological Survey) and 7.1 (Harvard Centroid-Moment-Tensor (CMT). More than 10 aftershocks ranging from 5.0 to 5.9 in magnitude (none of magnitude larger than 6.0) struck the area in hours following the main shock. Most of these aftershocks have occurred to the West of the mainshock in the Mirogoane Lakes region and its distribution suggests that the length of the rupture was around 70 km. The Harvard Centroid Moment Tensor (CMT) mechanism solution indicates lefth-lateral strike slip movement with a fault plane trending toward (strike = 251o ; dip = 70o; rake = 28o). In order to obtain the spatiotemporal slip distribution of a finite rupture model we have used teleseismic body wave and the Kikuchi and Kanamori's method [1]. Rupture velocity was constrained by using the directivity effect determined from a set of waveforms well recorded at regional and teleseismic distances [2]. Finally, we compared a map of aftershocks with the Coulomb stress changes caused by the event in the region [3]. [1]- Kikuchi, M., and Kanamori, H., 1982, Inversion of complex body waves: Bull. Seismol. Soc. Am., v. 72, p. 491-506. [2] Caldeira B., Bezzeghoud M, Borges JF, 2009; DIRDOP: a directivity approach to determining the seismic rupture velocity vector. J Seismology, DOI 10.1007/s10950-009-9183-x (http://www.springerlink.com/content/xp524g2225628773/) [3] -King, G. C. P

Sedimentary Geochemical and Palynological Evidence of Late-Holocene Paleoenvironmental Change from Baradères Bay, Haiti

NASA Astrophysics Data System (ADS)

Farrington, E. J.; Lane, C.; Hawkes, A.; Donnelly, J. P.; van Hengstum, P. J.; Woodruff, J. D.; Maio, C. V.; Grochocki, K. K.; Taylor, A. K.

2017-12-01

Paleoclimate studies in equatorial regions are essential to decipher the forcing mechanisms controlling tropical precipitation dynamics. Caribbean paleoclimate records are particularly sensitive to changes in tropical convection, as they reside on the edge of the annual migrational range of the Intertropical Convergence Zone and record perturbations to many Pacific and Atlantic climate forcings. Significant sub-regional variability exists in the modern Caribbean climate and responsible forcing mechanisms on centennial to millennial timescales are largely unresolved, as reliable paleohydrological records are geographically sparse. In this study we aim to determine regional paleoenvironmental change with a specific interest in an abrupt dry period between 3200 and 2400 14C yr BP inferred from an oxygen isotope record from the nearby Lake Miragoâne, Haiti. Chronologically synchronous results from a Barbados stalagmite indicate wet conditions, which imply contrasting sub-regional hydrological responses between the northern and southern Caribbean basin. The development of multiple proximal paleoenvironmental records allows for better assessment of sub-regional Caribbean climate dynamics and the verification of existing proxy trends. We are conducting multi-proxy analyses on a 6360 14C yr, 9-meter sediment core extracted from Baradères Bay, Haiti, including loss on ignition (LOI), bulk sediment carbon (δ13C) and nitrogen (δ15N) isotope geochemistry, n-alkane hydrogen (δD) isotope geochemistry, x-ray fluorescence (XRF), and fossil pollen counts. Preliminary LOI data reveal that between 6400 and 3000 14C yr B.P. inorganic carbon ranged from 15 to 30% and organic carbon from 8 to 20%. From 3000 14C yr B.P. to present organic content decreased (9 - 13%) and inorganic carbon content increased (28 - 30%). Preliminary pollen analyses show a decrease in Rhizophora (red mangrove) pollen abundances between 3000 and 4000 14C yr BP, possibly indicating a change in estuary

Evaluating the Sustained Health Impact of Household Chlorination of Drinking Water in Rural Haiti

PubMed Central

Harshfield, Eric; Lantagne, Daniele; Turbes, Anna; Null, Clair

2012-01-01

The Jolivert Safe Water for Families program has sold sodium hypochlorite solution (chlorine) and conducted household visits in rural Haiti since 2002. To assess the impact of the program on diarrheal disease, in 2010 we conducted a survey and water quality testing in 201 program participants and 425 control households selected at random. Fifty-six percent of participants (versus 10% of controls) had free chlorine residuals between 0.2 and 2.0 mg/L, indicating correct water treatment. Using intention-to-treat analysis, we found that significantly fewer children < 5 in participant households had an episode of diarrhea in the previous 48 hours (32% versus 52%; P < 0.001) with 59% reduced odds (odds ratio = 0.41, 95% confidence interval = 0.21–0.79). Treatment-on-treated estimates of the odds of diarrhea indicated larger program effects for participants who met more stringent verifications of participation. Diarrheal disease reduction in this long-term program was comparable with that seen in short-term randomized, controlled interventions, suggesting that household chlorination can be an effective long-term water treatment strategy. PMID:22987657

Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti

PubMed Central

Tilmans, Sebastien; Russel, Kory; Sklar, Rachel; Page, Leah; Kramer, Sasha

2015-01-01

Container-based sanitation (CBS) – in which wastes are captured in sealable containers that are then transported to treatment facilities – is an alternative sanitation option in urban areas where on-site sanitation and sewerage are infeasible. This paper presents the results of a pilot household CBS service in Cap Haitien, Haiti. We quantify the excreta generated weekly in a dense urban slum,(1) the proportion safely removed via container-based public and household toilets, and the costs associated with these systems. The CBS service yielded an approximately 3.5-fold decrease in the unmanaged share of faeces produced, and nearly eliminated the reported use of open defecation and “flying toilets” among service recipients. The costs of this pilot small-scale service were higher than those of large-scale waterborne sewerage, but economies of scale have the potential to reduce CBS costs over time. The paper concludes with a discussion of planning and policy implications of incorporating CBS into the menu of sanitation options for rapidly growing cities. PMID:26097288

Evaluating the sustained health impact of household chlorination of drinking water in rural Haiti.

PubMed

Harshfield, Eric; Lantagne, Daniele; Turbes, Anna; Null, Clair

2012-11-01

The Jolivert Safe Water for Families program has sold sodium hypochlorite solution (chlorine) and conducted household visits in rural Haiti since 2002. To assess the impact of the program on diarrheal disease, in 2010 we conducted a survey and water quality testing in 201 program participants and 425 control households selected at random. Fifty-six percent of participants (versus 10% of controls) had free chlorine residuals between 0.2 and 2.0 mg/L, indicating correct water treatment. Using intention-to-treat analysis, we found that significantly fewer children < 5 in participant households had an episode of diarrhea in the previous 48 hours (32% versus 52%; P < 0.001) with 59% reduced odds (odds ratio = 0.41, 95% confidence interval = 0.21-0.79). Treatment-on-treated estimates of the odds of diarrhea indicated larger program effects for participants who met more stringent verifications of participation. Diarrheal disease reduction in this long-term program was comparable with that seen in short-term randomized, controlled interventions, suggesting that household chlorination can be an effective long-term water treatment strategy.

Revision of the geological context of the Port-au-Prince, Haiti, metropolitan area: implications for seismic microzonation

NASA Astrophysics Data System (ADS)

Terrier, M.; Bialkowski, A.; Nachbaur, A.; Prépetit, C.; Joseph, Y. F.

2014-02-01

A geological study has been conducted in the framework of the microzonation of Port-au-Prince, Haiti. It reveals the deposit of Miocene and Pliocene formations in a marine environment and the impact on these deposits of the Enriquillo-Plantain Garden N80° E fault system and of N110° E faults. The tectonic and morphological analysis indicates motion during the Quaternary along several mapped reverse left-lateral N110° E faults affecting the capital. Assessing ground-movement hazards represents an integral component of seismic microzonation. The geological results have provided essential groundwork for this assessment. Seismic microzonation aims to take seismic risk more fully into account in the city's urbanization and development policies. To this end, assumptions are made as to risks induced by surface rupture and ground movement from active faults.

Integrated Strategies to Address Maternal and Child Health and Survival in Low-Income Settings: Implications for Haiti

PubMed Central

Bhutta, Zulfiqar A

2016-01-01

The Millennium Development Goals for improving maternal and child health globally were agreed on in 2000, and several monitoring and evaluation strategies were put in place, including “Countdown to 2015” for monitoring progress and intervention coverage to reach the goals. However, progress in achieving the goals has been slow, with only 13 of the 75 participating Countdown countries on track to reach the targets for reducing child mortality. An overview of child mortality rates in low-income countries is presented, followed by a discussion of evidenced-based interventions that can bridge the equity gaps in global health. Finally, comments are included on the companion article in this issue, “Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care” (page 59), and what is needed for that new project to succeed. PMID:27065474

Preliminary results on earthquake triggered landslides for the Haiti earthquake (January 2010)

NASA Astrophysics Data System (ADS)

van Westen, Cees; Gorum, Tolga

2010-05-01

This study presents the first results on an analysis of the landslides triggered by the Ms 7.0 Haiti earthquake that occurred on January 12, 2010 in the boundary region of the Pacific Plate and the North American plate. The fault is a left lateral strike slip fault with a clear surface expression. According to the USGS earthquake information the Enriquillo-Plantain Garden fault system has not produced any major earthquake in the last 100 years, and historical earthquakes are known from 1860, 1770, 1761, 1751, 1684, 1673, and 1618, though none of these has been confirmed in the field as associated with this fault. We used high resolution satellite imagery available for the pre and post earthquake situations, which were made freely available for the response and rescue operations. We made an interpretation of all co-seismic landslides in the epicentral area. We conclude that the earthquake mainly triggered landslide in the northern slope of the fault-related valley and in a number of isolated area. The earthquake apparently didn't trigger many visible landslides within the slum areas on the slopes in the southern part of Port-au-Prince and Carrefour. We also used ASTER DEM information to relate the landslide occurrences with DEM derivatives.

Violence and abuse of internally displaced women survivors of the 2010 Haiti earthquake.

PubMed

Campbell, Doris W; Campbell, Jacquelyn C; Yarandi, Hossein N; O'Connor, Annie Lewis; Dollar, Emily; Killion, Cheryl; Sloand, Elizabeth; Callwood, Gloria B; Cesar, Nicole M; Hassan, Mona; Gary, Faye

2016-11-01

Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. An interdisciplinary collaborative of researchers and practitioners in Haiti, the US Virgin Islands, and the US Mainland investigated gender-based violence (GBV) pre- and post-earthquake and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. A comparative descriptive correlational design using culturally sensitive and language appropriate computer-assisted interviews of 208 internally displaced women 2011-2013. Found high rates of violence and abuse both before (71.2 %) and after (75 %) p = 0.266, the earthquake primarily perpetrated by boy friends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The majority (60-78 %) of abused women did not report personal or community tolerance for violence and abuse, but acknowledged a community context of limited involvement. Coordinated planning and implementation of needed interventions are essential to provide a balanced approach to the care of displaced women after natural disasters with sensitivity to the abusive experiences of many women both before and after the disasters.

Violence and abuse of internally displaced women survivors of the 2010 Haiti earthquake

PubMed Central

Campbell, Jacquelyn C.; Yarandi, Hossein N.; O’Connor, Annie Lewis; Dollar, Emily; Killion, Cheryl; Sloand, Elizabeth; Callwood, Gloria B.; Cesar, Nicole M.; Hassan, Mona; Gary, Faye

2016-01-01

Objectives Limited research following disasters suggests that internally displaced women are disproportionately vulnerable to violence and abuse. An interdisciplinary collaborative of researchers and practitioners in Haiti, the US Virgin Islands, and the US Mainland investigated gender-based violence (GBV) pre- and post-earthquake and health outcomes among Haitian women living in tent cities/camps following the 2010 earthquake. Methods A comparative descriptive correlational design using culturally sensitive and language appropriate computer-assisted interviews of 208 internally displaced women 2011–2013. Results Found high rates of violence and abuse both before (71.2 %) and after (75 %) p = 0.266, the earthquake primarily perpetrated by boy friends or husbands. Significantly more mental and physical health problems were reported by abused than non-abused women. The majority (60–78 %) of abused women did not report personal or community tolerance for violence and abuse, but acknowledged a community context of limited involvement. Conclusions Coordinated planning and implementation of needed interventions are essential to provide a balanced approach to the care of displaced women after natural disasters with sensitivity to the abusive experiences of many women both before and after the disasters. PMID:27624625

Landslides triggered by the January 12, 2010 Port-au-Prince, Haiti Mw 7.0 earthquake

NASA Astrophysics Data System (ADS)

Xu, Chong

2014-05-01

The January 12, 2010 Port-au-Prince, Haiti earthquake (Mw 7.0) triggered tens of thousands of landslides. The purpose of this study is to investigate correlations of the occurrence of landslides and its erosion thickness with topographic factors, seismic parameters, and distance from roads. A total of 30,828 landslides triggered by the earthquake cover a total area of 15.736 km2, and the volume of landslide accumulation materials is estimated to be about 30,000,000 m3, and throughout an area more than 3,000 km2. These landslides are of various types, mainly in shallow disrupted landslides and rock falls, and also including coherent deep-seated landslides, shallow disrupted landslides, rock falls, and rock slides. These landslides were delineated using pre- and post-earthquake high-resolutions satellite images. Spatial distribution maps and contour maps of landslide number density, landslide area percentage, and landslide erosion thickness were respectively constructed in order to more intuitive to discover the spatial distribution patterns of the co-seismic landslides. Statistics of size distribution and morphometric parameters of the co-seismic landslides were carried out and were compared with other earthquake events. Four proxies of co-seismic landslides abundances, including landslides centroid number density (LCND), landslide top number density (LTND), landslide area percentage (LAP), and landslide erosion thickness (LET) were used to correlate the co-seismic landslides with various landslide controlling parameters. These controlling parameters include elevation, slope angle, slope aspect, slope curvature, topographic position, distance from drainages, stratum/lithology, distance from the epicenter, distance from the Enriquillo-Plantain Garden fault, distance along the fault, and peak ground acceleration (PGA). Comparing of controls of impact parameters on co-seismic landslides show that slope angle is the strongest impact parameter on co-seismic landslides

The Admission and Academic Placement of Students from the Caribbean. A Workshop Report: British Patterned Education, Cuba, the Dominican Republic, Dutch Patterned Education, the French West Indies, Haiti, Puerto Rico, and the U.S. Virgin Islands.

ERIC Educational Resources Information Center

Fish, Cynthia, Ed.

This workshop report examines the admission and academic placement of students from the Caribbean. Workshop materials concerning the educational systems of the British patterned Caribbean, Cuba, Dominican Republic; Dutch patterned Caribbean, French West Indies, Haiti, Puerto Rico; and the U.S. Virgin Islands are presented. Workshop recommendations…

Examining the association between possessing a regular source of healthcare and adherence with cancer screenings among Haitian households in Little Haiti, Miami-Dade County, Florida

PubMed Central

Pang, Hauchie; Cataldi, Mariel; Allseits, Emmanuelle; Ward-Peterson, Melissa; de la Vega, Pura Rodríguez; Castro, Grettel; Acuña, Juan Manuel

2017-01-01

Abstract Immigrant minorities regularly experience higher incidence and mortality rates of cancer. Frequently, a variety of social determinants create obstacles for those individuals to get the screenings they need. This is especially true for Haitian immigrants, a particularly vulnerable immigrant population in South Florida, who have been identified as having low cancer screening rates. While Haitian immigrants have some of the lowest cancer screening rates in the country, there is little existing literature that addresses barriers to cancer screenings among the population of Little Haiti in Miami-Dade County, Florida. The objective of this study was to evaluate the association between having a regular source of healthcare and adherence to recommended cancer screenings in the Little Haiti population of Miami. This secondary analysis utilized data collected from a random-sample, population-based household survey conducted from November 2011 to December 2012 among a geographic area approximating Little Haiti in Miami-Dade County, Florida. A total of 421 households identified as Haitian. The main exposure of interest was whether households possessed a regular source of care. Three separate outcomes were considered: adherence with colorectal cancer screening, mammogram adherence, and Pap smear adherence. Analysis was limited to households who met the age criteria for each outcome of interest. Bivariate associations were examined using the chi square test and Fisher exact test. Binary logistic regression was used to estimate unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). After adjusting for the head of household's education and household insurance status, households without a regular source of care were significantly less likely to adhere with colorectal cancer screening (OR = 0.33; 95% CI: 0.14–0.80) or mammograms (OR = 0.28; 95% CI: 0.11–0.75). Households with insurance coverage gaps were significantly less likely to

Earthquake source imaging by high-resolution array analysis at regional distances: the 2010 M7 Haiti earthquake as seen by the Venezuela National Seismic Network

NASA Astrophysics Data System (ADS)

Meng, L.; Ampuero, J. P.; Rendon, H.

2010-12-01

Back projection of teleseismic waves based on array processing has become a popular technique for earthquake source imaging,in particular to track the areas of the source that generate the strongest high frequency radiation. The technique has been previously applied to study the rupture process of the Sumatra earthquake and the supershear rupture of the Kunlun earthquakes. Here we attempt to image the Haiti earthquake using the data recorded by Venezuela National Seismic Network (VNSN). The network is composed of 22 broad-band stations with an East-West oriented geometry, and is located approximately 10 degrees away from Haiti in the perpendicular direction to the Enriquillo fault strike. This is the first opportunity to exploit the privileged position of the VNSN to study large earthquake ruptures in the Caribbean region. This is also a great opportunity to explore the back projection scheme of the crustal Pn phase at regional distances,which provides unique complementary insights to the teleseismic source inversions. The challenge in the analysis of the 2010 M7.0 Haiti earthquake is its very compact source region, possibly shorter than 30km, which is below the resolution limit of standard back projection techniques based on beamforming. Results of back projection analysis using the teleseismic USarray data reveal little details of the rupture process. To overcome the classical resolution limit we explored the Multiple Signal Classification method (MUSIC), a high-resolution array processing technique based on the signal-noise orthognality in the eigen space of the data covariance, which achieves both enhanced resolution and better ability to resolve closely spaced sources. We experiment with various synthetic earthquake scenarios to test the resolution. We find that MUSIC provides at least 3 times higher resolution than beamforming. We also study the inherent bias due to the interferences of coherent Green’s functions, which leads to a potential quantification

Medical student surgery elective in rural Haiti: a novel approach to satisfying clerkship requirements while providing surgical care to an underserved population.

PubMed

Chin-Quee, Anthony; White, Laura; Leeds, Ira; MacLeod, Jana; Master, Viraj A

2011-04-01

The addition of global health programs to medical school training results in graduates with enhanced clinical skills and increased sensitivity to cost issues. Funding from U.S. medical schools has been unable to meet student demand, and therefore it is often a critical limiting factor to the lack of development of these programs. We describe an alternative approach for global health surgical training for medical students. Emory University medical students and faculty, in collaboration with Project Medishare for Haiti, planned, raised funds, and executed a successful short-term surgical camp to supplement available surgical services in rural Haiti. Learning objectives that satisfied Emory University School of Medicine surgery clerkship requirements were crafted, and third-year students received medical school credit for the trip. In the absence of house staff and placed in an under-resourced, foreign clinical environment, the surgical elective described here succeeded in meeting learning objectives for a typical third-year surgical clerkship. Objectives were met through a determined effort to ensure that home institution requirements were aligned properly with learning activities while students were abroad and through a close collaboration between medical students, faculty members, and the administration. Emory University's international surgery elective for medical students demonstrates that opportunities for supervised, independent student-learning and global health service can be integrated into a traditional surgical clerkship. These opportunities can be organized to meet the requirements and expectations for third-year surgery clerkships at other medical colleges. This work also identifies how such trips can be planned and executed in a manner that does not burden strained academic budgets with further demands on resources.

Estimation of Surgery Capacity in Haiti: Nationwide Survey of Hospitals.

PubMed

Tran, Tu M; Saint-Fort, Mackenson; Jose, Marie-Djenane; Henrys, Jean Hugues; Pierre Pierre, Jacques B; Cherian, Meena N; Gosselin, Richard A

2015-09-01

Haiti's surgical capacity was significantly strained by the 2010 earthquake. As the government and its partners rebuild the health system, emergency and essential surgical care must be a priority. A validated, facility-based assessment tool developed by WHO was completed by 45 hospitals nationwide. The hospitals were assessed for (1) infrastructure, (2) human resources, (3) surgical interventions and emergency care, and (4) material resources for resuscitation. Fisher's exact test was used to compare hospitals by sectors: public compared to private and mixed (public-private partnerships). The 45 hospitals included first-referral level to the national referral hospital: 20 were public sector and 25 were private or mixed sector. Blood banks (33% availability) and oxygen concentrators (58%) were notable infrastructural deficits. For human resources, 69% and 33% of hospitals employed at least one full-time surgeon and anaesthesiologist, respectively. Ninety-eight percent of hospitals reported capacity to perform resuscitation. General and obstetrical surgical interventions were relatively more available, for example 93% provided hernia repairs and 98% provided cesarean sections. More specialized interventions were at a deficit: cataract surgery (27%), cleft repairs (31%), clubfoot (42%), and open treatment of fractures (51%). Deficiencies in infrastructure and material resources were widespread and should be urgently addressed. Physician providers were mal-distributed relative to non-physician providers. Formal task-sharing to midlevel and general physician providers should be considered. The parity between public and private or mixed sector hospitals in availability of Ob/Gyn surgical interventions is evidence of concerted efforts to reduce maternal mortality. This ought to provide a roadmap for strengthening of surgical care capacity.

Effectiveness of Oral Cholera Vaccine in Haiti: 37-Month Follow-Up.

PubMed

Sévère, Karine; Rouzier, Vanessa; Anglade, Stravinsky Benedict; Bertil, Claudin; Joseph, Patrice; Deroncelay, Alexandra; Mabou, Marie Marcelle; Wright, Peter F; Guillaume, Florence Duperval; Pape, Jean William

2016-05-04

The first oral cholera vaccine (OCV) campaign, since its prequalification by the World Health Organization, in response to an ongoing cholera epidemic (reactive vaccination) was successfully conducted in a poor urban slum of approximately 70,000 inhabitants in Port-au-Prince, Haiti, in 2012. Vaccine coverage was 75% of the target population. This report documents the impact of OCV in reducing the number of culture-confirmed cases of cholera admitted to the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) cholera treatment center from that community in the 37 months postvaccination (April 2012-April 30, 2015). Of 1,788 patients with culture-confirmed cholera, 1,770 (99%) were either from outside the vaccine area (1,400 cases) or from the vaccinated community who had not received OCV (370 cases). Of the 388 people from the catchment area who developed culture-confirmed cholera, 370 occurred among the 17,643 people who had not been vaccinated (2.1%) and the remaining 18 occurred among the 52,357 people (0.034%) who had been vaccinated (P < 0.001), for an efficacy that approximates 97.5%. Despite not being designed as a randomized control trial, the very high efficacy is a strong evidence for the effectiveness of OCV as part of an integrated package for the control of cholera in outbreak settings. © The American Society of Tropical Medicine and Hygiene.

Earthquake Damage Assessment over Port-au-Prince (Haiti) by Fusing Optical and SAR Data

NASA Astrophysics Data System (ADS)

Romaniello, V.; Piscini, A.; Bignami, C.; Anniballe, R.; Pierdicca, N.; Stramondo, S.

2016-08-01

This work proposes methodologies aiming at evaluating the sensitivity of optical and SAR change features obtained from satellite images with respect to the damage grade. The proposed methods are derived from the literature ([1], [2], [3], [4]) and the main novelty concerns the estimation of these change features at object scale.The test case is the Mw 7.0 earthquake that hit Haiti on January 12, 2010.The analysis of change detection indicators is based on ground truth information collected during a post- earthquake survey. We have generated the damage map of Port-au-Prince by considering a set of polygons extracted from the open source Open Street Map geo- database. The resulting damage map was calculated in terms of collapse ratio [5].We selected some features having a good sensitivity with damage at object scale [6]: the Normalised Difference Index, the Kullback-Libler Divergence, the Mutual Information and the Intensity Correlation Difference.The Naive Bayes and the Support Vector Machine classifiers were used to evaluate the goodness of these features. The classification results demonstrate that the simultaneous use of several change features from EO observations can improve the damage estimation at object scale.

Analysis of the international and US response to the Haiti earthquake: recommendations for change.

PubMed

Kirsch, Thomas; Sauer, Lauren; Guha Sapir, Debarati

2012-10-01

The 2010 earthquake in Haiti was unprecedented in its impact. The dual loss of the Haitian government and United Nations (UN) leadership led to an atypical disaster response driven by the US government and military. Although the response was massive, the leadership and logistical support were initially insufficient, and the UN cluster system struggled with the overwhelming influx of nontraditional agencies and individuals, which complicated the health care response. Moreover, the provision of care was beyond the country's health care standards. The management of the US government resembled a whole-of-government domestic response, combined with a massive military presence that went beyond logistical support. Among the most important lessons learned were the management of the response and how it could be strengthened by adapting a structure such as the domestic National Response Framework. Also, mechanisms were needed to increase the limited personnel to surge in a major response. One obvious pool has been the military, but the military needs to increase integration with the humanitarian community and improve its own humanitarian response expertise. In addition, information management needs standardized tools and analysis to improve its use of independent agencies.

The creation and integration of a nurse educator position in two hospitals in Haiti.

PubMed

Mahon, Abbey; Valcourt, Roodeline; Merry, Lisa; Dieudonné, Fabiola; Tuck, Jodi

2018-04-01

Continuing education is an integral part of nursing professional development and improving healthcare delivery, but literature on continuing education initiatives in low-resource settings is limited. To describe the creation and integration of a nurse educator (NE) position in two Haitian hospitals and highlight barriers and facilitators experienced by the NEs in their role. Four NEs and three support staff involved in the creation and integration of the NE positions were interviewed. Supplementary data were gathered through participant observation and document review. Data were compiled and summarized. NEs were hired to assess learning needs, evaluate skills, train and mentor nurses, and provide ongoing support to assure application of new knowledge. Barriers included lack of specialized training and limited informational resources to develop education activities, role confusion and heavy workload, poor attendance and disparate education needs of nurses, and insufficient hospital resources and support to implement practice changes. Facilitators included previous management experience, peer support, and a perception of being valued by patients and colleagues and making a difference regarding nursing care and patient outcomes. The NE is a leadership role and a promising, sustainable initiative for developing the nursing profession in Haiti. © 2018 Wiley Periodicals, Inc.

Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results.

PubMed

Beck-Sagué, Consuelo M; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W; Dorceus, Patricia; Preston, Sharice M; Dean, Andrew G; Nicholas, Stephen W; Blasini, Ileana

2015-06-01

To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. A quasi-experimental trial was conducted comparing caregiver-youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0-17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. To date, 65 Dominican Republic and 27 Haiti caregiver-youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM.

The MW 7.0 Haiti Earthquake of January 12, 2010: USGS/EERI Advance Reconnaissance Team Report

USGS Publications Warehouse

Eberhard, Marc O.; Baldridge, Steven; Marshall, Justin; Mooney, Walter; Rix, Glenn J.

2010-01-01

Executive Summary A field reconnaissance in Haiti by a five-member team with expertise in seismology and earthquake engineering has revealed a number of factors that led to catastrophic losses of life and property during the January 12, 2010, Mw 7.0 earthquake. The field study was conducted from January 26 to February 3, 2010, and included investigations in Port-au-Prince and the heavily damaged communities to the west, including Leogane, Grand Goave, Petite Goave, and Oliver. Seismology Despite recent seismic quiescence, Haiti has suffered similar devastating earthquakes in the historical past (1701, 1751, 1770 and 1860). Despite this knowledge of historical seismicity, Haiti had no seismograph stations during the main earthquake, so it is impossible to estimate accurately the intensity of ground motions. Nonetheless, the wide range of buildings damaged by the January 12, 2010, earthquake suggests that the ground motions contained seismic energy over a wide range of frequencies. Another earthquake of similar magnitude could strike at any time on the eastern end of the Enriquillo Fault, directly to the south of Port-au-Prince. Reconstruction must take this hazard into account. The four portable seismographs installed by the team recorded a series of small aftershocks. As expected, the ground motions recorded at a hard-rock site contained a greater proportion of high frequencies than the motions recorded at a soil site. Two of the stations continue to monitor seismic activity. A thorough field investigation of the mapped Enriquillo Fault south of the city of Leogane failed to find any evidence of surface faulting. This led the team to conclude that the earthquake was unlikely to have produced any surface rupture in the study area. Geotechnical Aspects Soil liquefaction, landslides and rockslides in cut slopes, and road embankment failures contributed to extensive damage in Port-au-Prince and elsewhere. A lack of detailed knowledge of the physical conditions of the

Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults survivors of earthquake in Haiti after 30 months.

PubMed

Cénat, Jude Mary; Derivois, Daniel

2014-04-01

On January 12, 2010, a powerful 7.0 magnitude earthquake struck the Republic of Haiti and destroyed Port-au-Prince, the capital and others cities across the country. While some studies have examined the long-term traumatic effects of the seismic event on children and adolescents victims, so far no study has examined the consequences on adults generally. As such, this study aims to investigate the traumatic consequences of the earthquake among adults related to degree of exposure, peritraumatic distress, depressive symptoms and sociodemographic factors two and a half years after. In addition, predictive factors of PTSD and depressive symptoms were also identified. From June to July 2012, a total of 1355 adults (660 women) was assessed by means the traumatic exposure questionnaire, the Life Events Checklist subscale, the Peritraumatic Distress Inventory (PDI), the Impact of Event Scale - Revised (IES-R) and the Beck Depression Inventory (BDI), in addition to social demographic characteristics. The prevalence rates of PTSD and depressive symptoms were 36.75% (498 cases) and 25.98% (352 cases) respectively. The risk factors for PTSD and depressive symptoms were young and old age, female gender, unemployed status and low level of education. The bests predictives variables were peritraumatic distress for PTSD (β=.57, p<.0001) and for depressive symptoms (β=.21, p<.0001). The commorbidity between PTSD and depression was 13.36%. This study found that psychological symptoms are frequent event 30 months after the earthquake. The different mental health care providers, the public health ministry, NGOs working on the ground in Haiti should design programmes in order to aid the psychological wellbeing of the population focussing on youth, older and retired adults, females, people with low levels of education and those who do not work. Copyright © 2014 Elsevier B.V. All rights reserved.

Access to safe water in rural Artibonite, Haiti 16 months after the onset of the cholera epidemic.

PubMed

Patrick, Molly; Berendes, David; Murphy, Jennifer; Bertrand, Fabienne; Husain, Farah; Handzel, Thomas

2013-10-01

Haiti has the lowest improved water and sanitation coverage in the Western Hemisphere and is suffering from the largest cholera epidemic on record. In May of 2012, an assessment was conducted in rural areas of the Artibonite Department to describe the type and quality of water sources and determine knowledge, access, and use of household water treatment products to inform future programs. It was conducted after emergency response was scaled back but before longer-term water, sanitation, and hygiene activities were initiated. The household survey and source water quality analysis documented low access to safe water, with only 42.3% of households using an improved drinking water source. One-half (50.9%) of the improved water sources tested positive for Escherichia coli. Of households with water to test, 12.7% had positive chlorine residual. The assessment reinforces the identified need for major investments in safe water and sanitation infrastructure and the importance of household water treatment to improve access to safe water in the near term.

High prevalence of asymptomatic malaria infections: a cross-sectional study in rural areas in six departments in Haiti.

PubMed

Elbadry, Maha A; Al-Khedery, Basima; Tagliamonte, Massimiliano S; Yowell, Charles A; Raccurt, Christian P; Existe, Alexandre; Boncy, Jacques; Weppelmann, Thomas A; Beau De Rochars, Valery E M; Lemoine, Jean F; Okech, Bernard A; Dame, John B

2015-12-21

Public health measures are poised for transition from malaria control to malaria elimination on the island of Hispaniola. Assessment of the reservoir of asymptomatic infections from which acute malaria cases may derive is critical to plan and evaluate elimination efforts. Current field technology is ill suited for detecting sub-microscopic infections, thus highly sensitive survey methods capable of detecting virtually all infections are needed. In this study the prevalence of infection with Plasmodium falciparum was determined in patients seeking medical care primarily for non-febrile conditions in six departments in Haiti using a newly designed qRT-PCR-based assay. Three different methods of parasite detection were compared to assess their utility in approximating the prevalence of P. falciparum infections in the population: malaria rapid diagnostic test (RDT) designed to detect histidine-rich protein 2 (HRP2), thick smear microscopy, and a quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay based upon the small sub-unit ribosomal RNA. The limit of detection of the qRT-PCR assay utilized was 0.0003 parasite/µL of blood. Venous blood was obtained from a total of 563 subjects from six departments in Haiti, all of whom were seeking medical attention without complaints consistent with malaria. Each subject was questioned for knowledge and behaviour using demographic and epidemiological survey to identify risk factors for disease transmission. Among the 563 samples tested, ten and 16 were found positive for malaria by RDT and microscopy, respectively. Using the qRT-PCR test to assess the infection status of these subjects, an additional 92 were identified for a total of 108. Based upon the qRT-PCR assay results, a wide variation in prevalence of infection in asymptomatic subjects was seen between geographic locations ranging from 4-41%. The prevalence of infection was highest in the Grand Anse, Nord and Sud-Est Departments, and demographic

Artemisinin Resistance-Associated Polymorphisms at the K13-Propeller Locus Are Absent in Plasmodium falciparum Isolates from Haiti

PubMed Central

Carter, Tamar E.; Boulter, Alexis; Existe, Alexandre; Romain, Jean R.; St. Victor, Jean Yves; Mulligan, Connie J.; Okech, Bernard A.

2015-01-01

Antimalarial drugs are a key tool in malaria elimination programs. With the emergence of artemisinin resistance in southeast Asia, an effort to identify molecular markers for surveillance of resistant malaria parasites is underway. Non-synonymous mutations in the kelch propeller domain (K13-propeller) in Plasmodium falciparum have been associated with artemisinin resistance in samples from southeast Asia, but additional studies are needed to characterize this locus in other P. falciparum populations with different levels of artemisinin use. Here, we sequenced the K13-propeller locus in 82 samples from Haiti, where limited government oversight of non-governmental organizations may have resulted in low-level use of artemisinin-based combination therapies. We detected a single-nucleotide polymorphism (SNP) at nucleotide 1,359 in a single isolate. Our results contribute to our understanding of the global genomic diversity of the K13-propeller locus in P. falciparum populations. PMID:25646258

Earthquake behavior of the Enriquillo fault zone, Haiti revealed by interactive terrain visualization

NASA Astrophysics Data System (ADS)

Cowgill, E.; Bernardin, T. S.; Oskin, M. E.; Bowles, C. J.; Yikilmaz, M. B.; Kreylos, O.; Elliott, A. J.; Bishop, M. S.; Gold, R. D.; Morelan, A.; Bawden, G. W.; Hamann, B.; Kellogg, L. H.

2010-12-01

The Mw 7.0 January 12, 2010 Haiti earthquake ended 240 years of relative quiescence following earthquakes that destroyed Port-au-Prince in 1751 and 1770. We place the 2010 rupture in the context of past earthquakes and future hazards by using remote analysis of airborne LiDAR to observe the topographic expression of active faulting and develop a new conceptual model for the earthquake behavior of the eastern Enriquillo fault zone (EFZ). In this model, the 2010 event occupies a long-lived segment boundary at a stepover within the EFZ separating fault segments that likely ruptured in 1751 and 1770, explaining both past clustering and the lack of 2010 surface rupture. Immediately following the 2010 earthquake, an airborne LiDAR point cloud containing over 2.7 billion point measurements of surface features was collected by the Rochester Inst. of Technology. To analyze these data, we capitalize on the human capacity to visually identify meaningful patterns embedded in noisy data by conducting interactive visual analysis of the entire 66.8 GB Haiti terrain data in a 4-sided, 800 ft3 immersive virtual-reality environment at the UC Davis KeckCAVES using the software tools LiDAR Viewer (to analyze point cloud data) and Crusta (for 3D surficial geologic mapping on DEM data). We discovered and measured landforms displaced by past surface-rupturing earthquakes and remotely characterized the regional fault geometry. Our analysis of the ~50 km long reach of EFZ spanning the 2010 epicenter indicates that geomorphic evidence of active faulting is clearer east of the epicenter than to the west. West of the epicenter, and in the region of the 2010 rupture, the fault is poorly defined along an embayed, low-relief range front, with little evidence of recent surface rupture. In contrast, landform offsets of 6 to 50 m along the reach of the EFZ east of the epicenter and closest to Port-au-Prince attest to repeated recent surface-rupturing earthquakes here. Specifically, we found and

Factors affecting compliance with colorectal cancer screening among households residing in the largely Haitian community of Little Haiti, Miami-Dade County, Florida: an observational study.

PubMed

Wilcox, Meredith Leigh; Acuña, Juan Manuel; de la Vega, Pura Rodriguez; Castro, Grettel; Madhivanan, Purnima

2015-05-01

The United States Black population is disproportionately affected by colorectal cancer (CRC) in terms of incidence and mortality. Studies suggest that screening rates are lower among Blacks compared with non-Hispanic Whites (NHWs). However, studies on CRC screening within Black subgroups are lacking. This study examined disparities in blood stool test (BST) compliance and colonoscopy use by race/ethnicity (Haitian, NHW, non-Hispanic Black [NHB], and Hispanic) among randomly selected households in Little Haiti, Miami-Dade County, Florida.This study used cross-sectional, health and wellness data from a random-sample, population-based survey conducted within 951 households in Little Haiti between November 2011 and December 2012. BST compliance and colonoscopy use were self-reported and defined, conservatively, as the use of BST within the past 2 years and the ever use of colonoscopy by any household member. Factors associated with BST compliance and colonoscopy use were identified using logistic regression models. Analyses were restricted to households containing at least 1 member ≥50 years (n = 666).Nearly half of the households were compliant with BST (rate [95% confidence interval (CI)] = 45% [41%-49%]) and completed colonoscopy (rate [95% CI] = 53% [49%-58%]). Compliance with BST was not associated with race/ethnicity (P = 0.76). Factors independently associated with BST compliance included low educational attainment (adjusted odds ratio [AOR] = 0.63, P = 0.03), being single (AOR = 0.47, P = 0.004), retirement (AOR = 1.96, P = 0.01), and the presence of diagnosed health problems (AOR = 1.24, P = 0.01). Colonoscopy use was lower among Haitian households (46%) compared with NHW (63%), NHB (62%), and Hispanic households (54%) (P = 0.002). Factors independently associated with colonoscopy use included identifying as NHB (compared with Haitian) (AOR = 1.80, P = 0.05), being single (AOR = 0.44, P = 0

Bacterial community structure transformed after thermophilically composting human waste in Haiti

PubMed Central

Kramer, Sasha; Roy, Monika; Reid, Francine C.; Dubinsky, Eric A.

2017-01-01

Recycling human waste for beneficial use has been practiced for millennia. Aerobic (thermophilic) composting of sewage sludge has been shown to reduce populations of opportunistically pathogenic bacteria and to inactivate both Ascaris eggs and culturable Escherichia coli in raw waste, but there is still a question about the fate of most fecal bacteria when raw material is composted directly. This study undertook a comprehensive microbial community analysis of composting material at various stages collected over 6 months at two composting facilities in Haiti. The fecal microbiota signal was monitored using a high-density DNA microarray (PhyloChip). Thermophilic composting altered the bacterial community structure of the starting material. Typical fecal bacteria classified in the following groups were present in at least half the starting material samples, yet were reduced below detection in finished compost: Prevotella and Erysipelotrichaceae (100% reduction of initial presence), Ruminococcaceae (98–99%), Lachnospiraceae (83–94%, primarily unclassified taxa remained), Escherichia and Shigella (100%). Opportunistic pathogens were reduced below the level of detection in the final product with the exception of Clostridium tetani, which could have survived in a spore state or been reintroduced late in the outdoor maturation process. Conversely, thermotolerant or thermophilic Actinomycetes and Firmicutes (e.g., Thermobifida, Bacillus, Geobacillus) typically found in compost increased substantially during the thermophilic stage. This community DNA-based assessment of the fate of human fecal microbiota during thermophilic composting will help optimize this process as a sanitation solution in areas where infrastructure and resources are limited. PMID:28570610

AIDS Diarrhea and Antiretroviral Drug Concentrations: A Matched-Pair Cohort Study in Port au Prince, Haiti

PubMed Central

Dillingham, Rebecca; Leger, Paul; Beauharnais, Carole-Anne; Miller, Erica; Kashuba, Angela; Jennings, Steven; Dupnik, Kathryn; Samie, Amidou; Eyma, Etna; Guerrant, Richard; Pape, Jean; Fitzgerald, Daniel

2011-01-01

Diarrhea in patients with acquired immunodeficiency syndrome (AIDS) may cause malabsorption of medications and failure of antiretroviral therapy (ART). We prospectively evaluated human immunodeficiency virus-1 (HIV-1)-infected patients with and without chronic diarrhea initiating ART in Haiti. We report mean plasma antiretroviral concentrations at 2 and 4 weeks. We measured plasma HIV-1 RNA levels at four points. Fifty-two HIV-1-infected patients (26 matched pairs) were enrolled. No differences in antiretroviral concentrations were detected. At week 24, 18/25 (72%) cases and 16/24 (68%) controls had undetectable plasma HIV-1 RNA levels (P = 0.69). Patients with plasma HIV-1 RNA levels > 50 copies/mL at week 24 had lower early efavirenz concentrations than patients with undetectable HIV-1 RNA (2,621 ng/mL versus 5,278 ng/mL; P = 0.02). Diarrhea at ART initiation does not influence plasma concentrations of the medications evaluated. Virologic outcome at Week 24 does correlate with efavirenz concentrations early in therapy but not with the presence of chronic diarrhea. PMID:21633022

Disclosure of their HIV status to perinatally infected youth using the adapted Blasini disclosure model in Haiti and the Dominican Republic: preliminary results

PubMed Central

Beck-Sagué, Consuelo M.; Dévieux, Jessy; Pinzón-Iregui, Maria Claudia; Lerebours-Nadal, Leonel; Abreu-Pérez, Rosa; Bertrand, Rachel; Rouzier, Vanessa; Gaston, Stephanie; Ibanez, Gladys; Halpern, Mina; Pape, Jean W.; Dorceus, Patricia; Preston, Sharice M.; Dean, Andrew G.; Nicholas, Stephen W.; Blasini, Ileana

2015-01-01

Objectives To assess the safety, acceptability, and preliminary efficacy of a culturally-adapted disclosure intervention for perinatally HIV-infected combined antiretroviral therapy patients in Haiti and the Dominican Republic. Design A quasi-experimental trial was conducted comparing caregiver–youth pairs who completed the intervention [adapted Blasini disclosure model (aBDM)] to pairs who discontinued aBDM participation before disclosure. aBDM consists of five components: structured healthcare worker training; one-on one pre-disclosure intervention/education sessions for youth (describing pediatric chronic diseases including cancer, diabetes and HIV) and for caregivers (strengthening capacity for disclosure); a scheduled supportive disclosure session; and one-on-one postdisclosure support for caregivers and youth. Methods Caregivers of nondisclosed combined antiretroviral therapy patients aged 10.0–17.8 years were invited to participate. Data were collected by separate one-on-one face-to-face interviews of caregivers and youth by study staff and medical record review by pediatricians at enrollment and 3 months after disclosure or after intervention discontinuation. Results To date, 65 Dominican Republic and 27 Haiti caregiver–youth pairs have enrolled. At enrollment, only 46.4% of youth had viral suppression and 43.4% of caregivers had clinically significant depressive symptomatology. To date, two serious study-related adverse events have occurred. Seven of the 92 (7.6%, 6 in the Dominican Republic) enrolled pairs discontinued participation before disclosure and 39 had completed postdisclosure participation. Median plasma HIV-RNA concentration was lower in youth who completed aBDM than in youth who discontinued participation before aBDM disclosure (<40 versus 8673 copies/ml; P = 0.027). Completers expressed considerable satisfaction with aBDM. Conclusion Preliminary results suggest safety, acceptability, and possible effectiveness of the aBDM. PMID:26049543

Microfinance Institutions' Successful Delivery Of Micronutrient Powders: A Randomized Trial In Rural Haiti.

PubMed

Baum, Aaron; Elize, Wesly; Jean-Louis, Florence

2017-11-01

Globally, two-thirds of child deaths could be prevented by increased provision of health interventions such as vaccines, micronutrient supplements, and water purification tablets. We report the results from a randomized controlled trial in Haiti during 2012 that tested whether microfinance institutions-which reach 200 million households worldwide-can effectively deliver health products. These institutions provide loans to underserved entrepreneurs, primarily poor women in rural areas. In the intervention group, micronutrient powders to improve the nutrition of young children were distributed at regularly occurring microfinance meetings by a trained borrower. In both the control and the intervention groups, nurses led seminars on nutrition and extended breastfeeding during microfinance meetings. At three-month follow-up, the mean difference in hemoglobin concentration between children in the intervention group and those in the control group was 0.28 grams per deciliter (g/dL)-with a subsample of younger children (under two years of age) showing greater relative improvement (0.46 g/dL)-and the odds ratio for children in the intervention group meeting the diagnostic criteria for anemia was 0.64. The results are similar to those of previous studies that evaluated micronutrient powder distribution through dedicated health institutions. Our findings suggest that microfinance institutions are a promising platform for the large-scale delivery of health products in low-income countries.

Performance of Charcoal Cookstoves for Haiti Part 1: Results from the Water Boiling Test

DOE Office of Scientific and Technical Information (OSTI.GOV)

Booker, Kayje; Han, Tae Won; Granderson, Jessica

2011-06-01

In April 2010, a team of scientists and engineers from Lawrence Berkeley National Lab (LBNL) and UC Berkeley, with support from the Darfur Stoves Project (DSP), undertook a fact-finding mission to Haiti in order to assess needs and opportunities for cookstove intervention. Based on data collected from informal interviews with Haitians and NGOs, the team, Scott Sadlon, Robert Cheng, and Kayje Booker, identified and recommended stove testing and comparison as a high priority need that could be filled by LBNL. In response to that recommendation, five charcoal stoves were tested at the LBNL stove testing facility using a modified formmore » of version 3 of the Shell Foundation Household Energy Project Water Boiling Test (WBT). The original protocol is available online. Stoves were tested for time to boil, thermal efficiency, specific fuel consumption, and emissions of CO, CO{sub 2}, and the ratio of CO/CO{sub 2}. In addition, Haitian user feedback and field observations over a subset of the stoves were combined with the experiences of the laboratory testing technicians to evaluate the usability of the stoves and their appropriateness for Haitian cooking. The laboratory results from emissions and efficiency testing and conclusions regarding usability of the stoves are presented in this report.« less

Localized damage caused by topographic amplification during the 2010 M7.0 Haiti earthquake

USGS Publications Warehouse

Hough, S.E.; Altidor, J.R.; Anglade, D.; Given, D.; Janvier, M.G.; Maharrey, J.Z.; Meremonte, M.; Mildor, B.S.-L.; Prepetit, C.; Yong, A.

2010-01-01

Local geological conditions, including both near-surface sedimentary layers and topographic features, are known to significantly influence ground motions caused by earthquakes. Microzonation maps use local geological conditions to characterize seismic hazard, but commonly incorporate the effect of only sedimentary layers. Microzonation does not take into account local topography, because significant topographic amplification is assumed to be rare. Here we show that, although the extent of structural damage in the 2010 Haiti earthquake was primarily due to poor construction, topographic amplification contributed significantly to damage in the district of Petionville, south of central Port-au-Prince. A large number of substantial, relatively well-built structures situated along a foothill ridge in this district sustained serious damage or collapse. Using recordings of aftershocks, we calculate the ground motion response at two seismic stations along the topographic ridge and at two stations in the adjacent valley. Ground motions on the ridge are amplified relative to both sites in the valley and a hard-rock reference site, and thus cannot be explained by sediment-induced amplification. Instead, the amplitude and predominant frequencies of ground motion indicate the amplification of seismic waves by a narrow, steep ridge. We suggest that microzonation maps can potentially be significantly improved by incorporation of topographic effects. ?? 2010 Macmillan Publishers Limited. All rights reserved.

Subbottom seismic profiling survey of Lake Azuei, Haiti: Seismic signature of paleo-shorelines in a transpressional environment and possible tectonic implications

NASA Astrophysics Data System (ADS)

Sloan, H.; Cormier, M. H.; Boisson, D.; Brown, B.; Guerrier, K.; Hearn, C. K.; Heil, C. W., Jr.; Hines, L.; Kelly, R. P.; King, J. W.; Knotts, P.; Lucier, O. F.; Momplaisir, R.; Stempel, R.; Symithe, S. J.; Ulysse, S. M. J.; Wattrus, N. J.

2017-12-01

The left-lateral Enriquillo-Plantain Garden Fault (EPGF) is one of two major transform faults that form the North American-Caribbean plate boundary. GPS measurements indicate that relative motion evolves from nearly pure strike-slip in western Haiti to highly transpressional near Lake Azuei in eastern Haiti, where the EPGF may terminate against a south-dipping oblique reverse fault. Lake Azuei, one of the largest lakes in the Caribbean region (10 km x 23 km), is surrounded by two high-elevation sierras (> 2,000 m). Because the lake has no outlet to the sea, its level is sensitive to variations in precipitation and is thought to have fluctuated by 10's of meters during the Holocene. A rise of 5 m over the past 10 years has had a devastating impact, submerging villages, farmland, and roads. A grid of high-resolution ( 10 cm) subbottom seismic (CHIRP) profiles acquired in January 2017 captures the subtle signature of the 5 m-deep shoreline and also images a prominent paleo-shoreline at 10 m water depth. This 10 m paleo-shoreline is well expressed in the CHIRP data suggesting it was occupied for a long period of time. It is buried beneath a thin (< 20 cm-thick) veneer of sediments, indicating that it was submerged centuries to millennia ago. This paleo-shoreline represents a key horizontal marker that may have been warped by local transpressional tectonics. We therefore catalogued its varying seismic signature with the goal of detecting any subtle but systematic depth variations of the associated shoreline angle around the periphery of the lake. Two sediment cores, collected in water depths of 14 m and 17 m, each bottomed 80-90 cm below the lakebed into a distinctively coarser bed. On-going radiometric dating is expected to constrain the age of this distinctive layer. Should this layer be tied to the perduring 10-m lowstand of the lake, determining its age could help quantify vertical deformation rates around Lake Azuei.

Artemisinin resistance-associated polymorphisms at the K13-propeller locus are absent in Plasmodium falciparum isolates from Haiti.

PubMed

Carter, Tamar E; Boulter, Alexis; Existe, Alexandre; Romain, Jean R; St Victor, Jean Yves; Mulligan, Connie J; Okech, Bernard A

2015-03-01

Antimalarial drugs are a key tool in malaria elimination programs. With the emergence of artemisinin resistance in southeast Asia, an effort to identify molecular markers for surveillance of resistant malaria parasites is underway. Non-synonymous mutations in the kelch propeller domain (K13-propeller) in Plasmodium falciparum have been associated with artemisinin resistance in samples from southeast Asia, but additional studies are needed to characterize this locus in other P. falciparum populations with different levels of artemisinin use. Here, we sequenced the K13-propeller locus in 82 samples from Haiti, where limited government oversight of non-governmental organizations may have resulted in low-level use of artemisinin-based combination therapies. We detected a single-nucleotide polymorphism (SNP) at nucleotide 1,359 in a single isolate. Our results contribute to our understanding of the global genomic diversity of the K13-propeller locus in P. falciparum populations. © The American Society of Tropical Medicine and Hygiene.

Performance of the CareStart Glucose-6-Phosphate Dehydrogenase (G6PD) Rapid Diagnostic Test in Gressier, Haiti

PubMed Central

von Fricken, Michael E.; Weppelmann, Thomas A.; Eaton, Will T.; Masse, Roseline; Beau de Rochars, Madsen V. E.; Okech, Bernard A.

2014-01-01

Administering primaquine (PQ) to treat malaria patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency can pose a serious risk of drug-induced hemolysis (DIH). New easy to use point-of-care rapid diagnostic tests are being developed as an alternative to labor-intensive spectrophotometric methods, but they require field testing before they can be used at scale. This study screened 456 participants in Gressier, Haiti using the Access Bio CareStart qualitative G6PD rapid detection test compared with the laboratory-based Trinity Biotech quantitative spectrophotometric assay. Findings suggest that the CareStart test was 90% sensitive for detecting individuals with severe deficiency and 84.8% sensitive for detecting individuals with moderate and severe deficiency compared with the Trinity Biotech assay. A high negative predictive value of 98.2% indicates excellent performance in determining those patients able to take PQ safely. The CareStart G6PD test holds much value for screening malaria patients to determine eligibility for PQ therapy. PMID:24778197

Seroepidemiologic Survey of Epidemic Cholera in Haiti to Assess Spectrum of Illness and Risk Factors for Severe Disease

PubMed Central

Jackson, Brendan R.; Talkington, Deborah F.; Pruckler, James M.; Fouché, M. D. Bernadette; Lafosse, Elsie; Nygren, Benjamin; Gómez, Gerardo A.; Dahourou, Georges A.; Archer, W. Roodly; Payne, Amanda B.; Hooper, W. Craig; Tappero, Jordan W.; Derado, Gordana; Magloire, Roc; Gerner-Smidt, Peter; Freeman, Nicole; Boncy, Jacques; Mintz, Eric D.

2013-01-01

To assess the spectrum of illness from toxigenic Vibrio cholerae O1 and risk factors for severe cholera in Haiti, we conducted a cross-sectional survey in a rural commune with more than 21,000 residents. During March 22–April 6, 2011, we interviewed 2,622 residents ≥ 2 years of age and tested serum specimens from 2,527 (96%) participants for vibriocidal and antibodies against cholera toxin; 18% of participants reported a cholera diagnosis, 39% had vibriocidal titers ≥ 320, and 64% had vibriocidal titers ≥ 80, suggesting widespread infection. Among seropositive participants (vibriocidal titers ≥ 320), 74.5% reported no diarrhea and 9.0% had severe cholera (reported receiving intravenous fluids and overnight hospitalization). This high burden of severe cholera is likely explained by the lack of pre-existing immunity in this population, although the virulence of the atypical El Tor strain causing the epidemic and other factors might also play a role. PMID:24106192

The barriers to environmental sustainability in post-disaster settings: a case study of transitional shelter implementation in Haiti.

PubMed

Abrahams, Daniel

2014-04-01

Disaster recovery operations that do not account for environmental sustainability (ES) risk exacerbating the impact of the disaster and hindering long-term recovery efforts. Yet aid agencies do not always consider ES. This research is a case study of the recovery that followed the 2010 earthquake in Haiti. Using timber and concrete procurement as proxies for broader post-disaster operations, research examined perceptions of ES as well as attempts at and barriers to incorporating it into programming. Identified barriers can be grouped into two categories: (1) prioritisations and perceptions within the disaster response sector that resulted in limited enthusiasm for incorporating ES into programming, and (2) structural and organisational barriers within the disaster response framework that impeded ES attempts and served as a further disincentive to incorporating ES into programming. As a result of those barriers, incorporation of ES was sporadic and inconsistent and often depended on the capacity and motivation of specific implementers. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Access to Safe Water in Rural Artibonite, Haiti 16 Months after the Onset of the Cholera Epidemic

PubMed Central

Patrick, Molly; Berendes, David; Murphy, Jennifer; Bertrand, Fabienne; Husain, Farah; Handzel, Thomas

2013-01-01

Haiti has the lowest improved water and sanitation coverage in the Western Hemisphere and is suffering from the largest cholera epidemic on record. In May of 2012, an assessment was conducted in rural areas of the Artibonite Department to describe the type and quality of water sources and determine knowledge, access, and use of household water treatment products to inform future programs. It was conducted after emergency response was scaled back but before longer-term water, sanitation, and hygiene activities were initiated. The household survey and source water quality analysis documented low access to safe water, with only 42.3% of households using an improved drinking water source. One-half (50.9%) of the improved water sources tested positive for Escherichia coli. Of households with water to test, 12.7% had positive chlorine residual. The assessment reinforces the identified need for major investments in safe water and sanitation infrastructure and the importance of household water treatment to improve access to safe water in the near term. PMID:24106191

Detection and phylogenetic characterization of arbovirus dual-infections among persons during a chikungunya fever outbreak, Haiti 2014.

PubMed

White, Sarah K; Mavian, Carla; Elbadry, Maha A; Beau De Rochars, Valery Madsen; Paisie, Taylor; Telisma, Taina; Salemi, Marco; Lednicky, John A; Morris, J Glenn

2018-05-01

In the context of recent arbovirus epidemics, questions about the frequency of simultaneous infection of patients with different arbovirus species have been raised. In 2014, a major Chikungunya virus (CHIKV) epidemic impacted the Caribbean and South America. As part of ongoing screening of schoolchildren presenting with acute undifferentiated febrile illness in rural Haiti, we used RT-PCR to identify CHIKV infections in 82 of 100 children with this diagnosis during May-August 2014. Among these, eight were infected with a second arbovirus: six with Zika virus (ZIKV), one with Dengue virus serotype 2, and one with Mayaro virus (MAYV). These dual infections were only detected following culture of the specimen, suggesting low viral loads of the co-infecting species. Phylogenetic analyses indicated that the ZIKV and MAYV strains differ from those detected later in 2014 and 2015, respectively. Moreover, CHIKV and ZIKV strains from co-infected patients clustered monophyletically in their respective phylogeny, and clock calibration traced back the common ancestor of each clade to an overlapping timeframe of introduction of these arboviruses onto the island.

What will it take to maintain the maternal and child health gains made in Haiti prior to the 2010 earthquake?: an analysis of past progress, trends, and the prospects for the realization of the United Nations Millennium Development Goals 4 and 5.

PubMed

Amibor, Paulson

2013-10-01

This report assesses the commendable progress made in maternal and child mortality reductions in Haiti prior to the January 2010 earthquake. Suggested measures that the Haitian government and international donor community can take to maintain these gains are also made. With the Millennium Development Goals (MDGs) deadline of 2015 drawing nearer, the likelihood that Haiti will achieve MDG's 4 and 5 of reducing child and maternal mortality by two-thirds and three-quarters, respectively, by the end of this target year, remain questionable. In particular, the destruction inflicted on the country's health care system and health infrastructure by the 2010 earthquake have already resulted in a slowing of these gains and could potentially threaten an actual reversal of these trends. The country's Soins Obstétricaux Gratuits and Soins Infantiles Gratuits schemes established in 2008 and 2010, which provide free health care to women, newborns and children under 5, represent examples of measures that will need to be sustained and scaled up if the country is to meet its MDG 4 and 5 targets. The Haitian government's endorsement of an increased continuum of care approach to maternal and newborn health will also be vital for future initiatives. Post-quake public health and social service reconstruction efforts will need to incorporate maternal and child health-friendly services into their designs. It also remains critical that international donors continue to meet their pledges to Haiti. The Haitian government should also take more strides to clearly delineate the maternal and child health interventions it implements, both in order to facilitate greater national learning, as well as to improve the likelihood of future replication.

Terrain Classification of Aster gDEM for Seismic Microzonation of Port-Au Haiti, Using - and - Based Analytic Methods

NASA Astrophysics Data System (ADS)

Yong, A.; Hough, S. E.; Cox, B. R.; Rathje, E. M.; Bachhuber, J.; Hulslander, D.; Christiansen, L.; Abrams, M.

2010-12-01

The aftermath of the M7.0 Haiti earthquake of 12 January 2010 witnessed an impressive scientific response from the international community. In addition to conventional post-earthquake investigations, there was also an unprecedented reliance on remote-sensing technologies for scientific investigation and damage assessment. These technologies include sensors from both aerial and space-borne observational platforms. As part of the Haiti earthquake response and recovery effort, we develop a seismic zonation map of Port-au-Prince based on high-resolution satellite imagery as well as data from traditional seismographic monitoring stations and geotechnical site characterizations. Our imagery consists of a global digital elevation model (gDEM) of Hispaniola derived from data recorded by NASA-JPL's Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) instrument onboard the multi-platform satellite Terra. To develop our model we also consider recorded waveforms from portable seismographic stations (Hough et al., in review) and 36 geotechnical shear-wave velocity surveys (Cox et al., in review). Following a similar approach developed by Yong et al. (2008; Bull. Seism Soc. Am.), we use both pixel- and object- based imaging analytic methods to systematically identify and extract local terrain features that are expected to amplify seismic ground motion. Using histogram-stretching techniques applied to the rDEM values, followed by multi-resolution, segmentations of the imagery into terrain types, we systematically classify the terrains of Hispaniola. By associating available Vs30 (average shear-wave velocity in the upper 30 meter depth) calculated from the MASW (Multi-channel Analysis of Surface Wave) survey method, we develop a first-order site characterization map. Our results indicate that the terrain-based Vs30 estimates are significantly associated with amplitudes recorded at station sites. We also find that the damage distribution inferred from UNOSAT

Improved Response to Disasters and Outbreaks by Tracking Population Movements with Mobile Phone Network Data: A Post-Earthquake Geospatial Study in Haiti

PubMed Central

Bengtsson, Linus; Lu, Xin; Thorson, Anna; Garfield, Richard; von Schreeb, Johan

2011-01-01

Background Population movements following disasters can cause important increases in morbidity and mortality. Without knowledge of the locations of affected people, relief assistance is compromised. No rapid and accurate method exists to track population movements after disasters. We used position data of subscriber identity module (SIM) cards from the largest mobile phone company in Haiti (Digicel) to estimate the magnitude and trends of population movements following the Haiti 2010 earthquake and cholera outbreak. Methods and Findings Geographic positions of SIM cards were determined by the location of the mobile phone tower through which each SIM card connects when calling. We followed daily positions of SIM cards 42 days before the earthquake and 158 days after. To exclude inactivated SIM cards, we included only the 1.9 million SIM cards that made at least one call both pre-earthquake and during the last month of study. In Port-au-Prince there were 3.2 persons per included SIM card. We used this ratio to extrapolate from the number of moving SIM cards to the number of moving persons. Cholera outbreak analyses covered 8 days and tracked 138,560 SIM cards. An estimated 630,000 persons (197,484 Digicel SIM cards), present in Port-au-Prince on the day of the earthquake, had left 19 days post-earthquake. Estimated net outflow of people (outflow minus inflow) corresponded to 20% of the Port-au-Prince pre-earthquake population. Geographic distribution of population movements from Port-au-Prince corresponded well with results from a large retrospective, population-based UN survey. To demonstrate feasibility of rapid estimates and to identify areas at potentially increased risk of outbreaks, we produced reports on SIM card movements from a cholera outbreak area at its immediate onset and within 12 hours of receiving data. Conclusions Results suggest that estimates of population movements during disasters and outbreaks can be delivered rapidly and with potentially high

Multiple traumas and resilience among street children in Haiti: Psychopathology of survival.

PubMed

Cénat, Jude Mary; Derivois, Daniel; Hébert, Martine; Amédée, Laetitia Mélissande; Karray, Amira

2018-05-01

In Haiti, as in several developing countries, the phenomenon of street children has become a major public health issue. These children are often victims of traumas and adverse life events. This article aimed to investigate traumas experienced by street children and their coping and resilience strategies used to deal with adversities in a logic of survival, relying on a mixed method approach. A group of 176 street children, aged 7-18 (n = 21 girls), recruited in Port-au-Prince, completed measures assessing PTSD, social support and resilience. Semi-structured interviews were conducted to document traumatic experiences, factors related to resilience and coping strategies. After performing statistical analyses to evaluate prevalence and predictors associated with PTSD, and level of social support satisfaction and resilience, qualitative analysis using a grounded theory approach was conducted. Results showed that street children experienced multiple traumas such as neglect, maltreatment, psychological, physical and sexual abuse. However, they also showed self-efficacy to face their traumatic experiences and few of them (less than 15%) obtained scores reaching clinical rates of PTSD, while a large majority presented a level of resilience between moderate to very high. A socio-ecological model of multiple traumas and a model of coping, survival and resilience strategies are conceptualized. Data provide a better understanding of the traumas experienced by street children, their coping and resilience strategies. Results underscore ways to develop practices to offer psychological support, social and vocational integration based on the real needs of these children, in a perspective of social justice. Copyright © 2018 Elsevier Ltd. All rights reserved.

Rio Soliette (haiti): AN International Initiative for Flood-Hazard Assessment and Mitigation

NASA Astrophysics Data System (ADS)

Gandolfi, S.; Castellarin, A.; Barbarella, M.; Brath, A.; Domeneghetti, A.; Brandimarte, L.; Di Baldassarre, G.

2013-01-01

Natural catastrophic events are one of most critical aspects for health and economy all around the world. However, the impact in a poor region can impact more dramatically than in others countries. Isla Hispaniola (Haiti and the Dominican Republic), one of the poorest regions of the planet, has repeatedly been hit by catastrophic natural disasters that caused incalculable human and economic losses. After the catastrophic flood event occurred in the basin of River Soliette on May 24th, 2004, the General Direction for Development and Cooperation of the Italian Department of Foreign Affairs funded an international cooperation initiative (ICI) coordinated by the University of Bologna, that involved Haitian and Dominican institutions.Main purpose of the ICI was hydrological and hydraulic analysis of the May 2004 flood event aimed at formulating a suitable and affordable flood risk mitigation plan, consisting of structural and non-structural measures. In this contest, a topographic survey was necessary to realize the hydrological model and to improve the knowledge in some areas candidates to be site for mitigation measures.To overcome the difficulties arising from the narrowness of funds, surveyors and limited time available for the survey, only GPS technique have been used, both for framing aspects (using PPP approach), and for geometrical survey of the river by means of river cross-sections and detailed surveys in two areas (RTK technique). This allowed us to reconstruct both the river geometry and the DTM's of two expansion areas (useful for design hydraulic solutions for mitigate flood-hazard risk).

International aid and natural disasters: a pre- and post-earthquake longitudinal study of the healthcare infrastructure in Leogane, Haiti.

PubMed

Kligerman, Maxwell; Barry, Michele; Walmer, David; Bendavid, Eran

2015-02-01

The reconstruction of healthcare systems in developing countries after natural disasters is poorly understood. Using data collected before and after the 2010 Haiti earthquake, we detail the response of aid agencies and their interaction with local healthcare providers in Leogane, the city closest to the epicenter. We find that the period after the earthquake was associated with an increase in the total number of healthcare facilities, inpatient beds, and surgical facilities and that international aid has been a driving force behind this recovery. Aid has funded 12 of 13 new healthcare facilities that have opened since the earthquake as well as the reconstruction of 7 of 8 healthcare facilities that have been rebuilt. Despite increases in free, aid-financed healthcare, private Haitian healthcare facilities have remained at a constant number. The planned phase-out of several aid-financed facilities, however, will leave Leogane with fewer inpatient beds and healthcare services compared with the pre-earthquake period. © The American Society of Tropical Medicine and Hygiene.

Ascaris and Escherichia coli Inactivation in an Ecological Sanitation System in Port-au-Prince, Haiti.

PubMed

Berendes, David; Levy, Karen; Knee, Jackie; Handzel, Thomas; Hill, Vincent R

2015-01-01

The goal of this study was to evaluate the microbial die-off in a latrine waste composting system in Port-au-Prince, Haiti. Temperature data and samples were collected from compost aged 0-12+ months. Samples collected from compost bin centers and corners at two depths were assessed for moisture content, E. coli concentration, and Ascaris spp. viability. Center temperatures in compost bins were all above 58 °C, while corner temperatures were 10 - 20 °C lower. Moisture content was 67 ± 10% in all except the oldest compost. A 4-log reduction in E. coli was observed over the first sixteen weeks of composting at both locations and depths, after which E. coli was undetectable (LOD: 142 MPN g(-1) dry weight). In new compost, 10.4% and 8.3% of Ascaris eggs were viable and fully embryonated, respectively. Percent viability dropped to zero in samples older than six weeks. These findings indicate that the Haitian EcoSan composting process was effective in inactivating E. coli and Ascaris spp. in latrine waste within sixteen weeks. This study is one of the first to document efficacy of an ecological sanitation system under field conditions and provides insight into composting methods and monitoring for other international settings.

Structure and management of tuberculosis control programs in fragile states--Afghanistan, DR Congo, Haiti, Somalia.

PubMed

Mauch, Verena; Weil, Diana; Munim, Aayid; Boillot, Francois; Coninx, Rudi; Huseynova, Sevil; Powell, Clydette; Seita, Akihiro; Wembanyama, Henriette; van den Hof, Susan

2010-07-01

Health care delivery is particularly problematic in fragile states often connected with increased incidence of communicable diseases, among them tuberculosis. This article draws upon experiences in tuberculosis control in four fragile states from which four lessons learned were derived. A structured inventory to extract common themes specific for TB control in fragile states was conducted among twelve providers of technical assistance who have worked in fragile states. The themes were applied to the TB control programs of Afghanistan, DR Congo, Haiti and Somalia during the years 2000-2006. Case notifications and treatment outcomes have increased in all four countries since 2003 (treatment success rates 81-90%). Access to care and case detection however have remained insufficient (case detection rates 39-62%); There are four lessons learned: 1. TB control programs can function in fragile states. 2. National program leadership and stewardship are essential for quality and sustained TB control. 3. Partnerships with non-governmental providers are vital for continuous service delivery; 4. TB control programs in fragile states require consistent donor support. Despite challenges in management, coordination, security, logistics and funding, TB control programs can function in fragile states, but face considerable problems in access to diagnosis and treatment and therefore case detection. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Effectiveness of reactive oral cholera vaccination in rural Haiti: a case-control study and bias-indicator analysis.

PubMed

Ivers, Louise C; Hilaire, Isabelle J; Teng, Jessica E; Almazor, Charles P; Jerome, J Gregory; Ternier, Ralph; Boncy, Jacques; Buteau, Josiane; Murray, Megan B; Harris, Jason B; Franke, Molly F

2015-03-01

Between April and June, 2012, a reactive cholera vaccination campaign was done in Haiti with an oral inactivated bivalent whole-cell vaccine. We aimed to assess the effectiveness of the vaccine in a case-control study and to assess the likelihood of bias in that study in a bias-indicator study. Residents of Bocozel or Grand Saline who were eligible for the vaccination campaign (ie, age ≥12 months, not pregnant, and living in the region at the time of the vaccine campaign) were included. In the primary case-control study, cases had acute watery diarrhoea, sought treatment at one of three participating cholera treatment units, and had a stool sample positive for cholera by culture. For each case, four control individuals who did not seek treatment for acute watery diarrhoea were matched by location of residence, enrolment time (within 2 weeks of the case), and age (1-4 years, 5-15 years, and >15 years). Cases in the bias-indicator study were individuals with acute watery diarrhoea with a negative stool sample for cholera. Controls were selected in the same manner as in the primary case-control study. Trained staff used standard laboratory procedures to do rapid tests and stool cultures from study cases. Participants were interviewed to collect data on sociodemographic characteristics, risk factors for cholera, and self-reported vaccination. Data were analysed by conditional logistic regression, adjusting for matching factors. From Oct 24, 2012, to March 9, 2014, 114 eligible individuals presented with acute watery diarrhoea and were enrolled, 25 of whom were subsequently excluded. 47 participants were analysed as cases in the vaccine effectiveness case-control study and 42 as cases in the bias-indicator study. 33 (70%) of 47 cholera cases self-reported vaccination versus 167 (89%) of 188 controls (vaccine effectiveness 63%, 95% CI 8-85). 27 (57%) of 47 cases had certified vaccination versus 147 (78%) of 188 controls (vaccine effectiveness 58%, 13-80). Neither self

Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

PubMed

deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

2018-03-01

Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

A randomized trial of ready-to-use supplementary food versus corn-soy blend plus as food rations for HIV-infected adults on antiretroviral therapy in rural Haiti.

PubMed

Ivers, Louise C; Teng, Jessica E; Jerome, J Gregory; Bonds, Matthew; Freedberg, Kenneth A; Franke, Molly F

2014-04-01

The epidemics of food insecurity, malnutrition, and human immunodeficiency virus (HIV) frequently overlap. HIV treatment programs increasingly provide nutrient-dense ready-to-use supplementary foods (RUSFs) to patients living with HIV and food insecurity, but in the absence of wasting, it is not known if RUSF confers benefit above less costly food commodities. We performed a randomized trial in rural Haiti comparing an RUSF with less costly corn-soy blend plus (CSB+) as a monthly supplement to patients with HIV infection who were on antiretroviral therapy (ART) <24 months prior to study start. We compared 6- and 12-month outcomes by ration type in terms of immunologic response, body mass index (BMI), adherence to ART, general health quality of life, household food insecurity, and household wealth. A cohort of 524 patients with HIV receiving ART was randomized and followed over time. Median CD4 cell count at baseline was 339 cells/µL (interquartile range [IQR], 197-475 cells/µL) for the CSB+ group, and 341 cells/µL (IQR, 213-464/µL) for the RUSF group. Measured outcomes improved from baseline over time, but there were no statistically significant differences in change for BMI, household wealth index, hunger, general health perception score, or adherence to ART by ration type at 6 or 12 months. The RUSF group had higher CD4 count at 12 months, but this was also not statistically significant. In 12 months of follow-up, there was no statistically significant difference in outcomes between those receiving RUSF-based compared with CSB+-based rations in a cohort of HIV-infected adults on ART in rural Haiti.

Performance of the CareStart glucose-6-phosphate dehydrogenase (G6PD) rapid diagnostic test in Gressier, Haiti.

PubMed

von Fricken, Michael E; Weppelmann, Thomas A; Eaton, Will T; Masse, Roseline; Beau de Rochars, Madsen V E; Okech, Bernard A

2014-07-01

Administering primaquine (PQ) to treat malaria patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency can pose a serious risk of drug-induced hemolysis (DIH). New easy to use point-of-care rapid diagnostic tests are being developed as an alternative to labor-intensive spectrophotometric methods, but they require field testing before they can be used at scale. This study screened 456 participants in Gressier, Haiti using the Access Bio CareStart qualitative G6PD rapid detection test compared with the laboratory-based Trinity Biotech quantitative spectrophotometric assay. Findings suggest that the CareStart test was 90% sensitive for detecting individuals with severe deficiency and 84.8% sensitive for detecting individuals with moderate and severe deficiency compared with the Trinity Biotech assay. A high negative predictive value of 98.2% indicates excellent performance in determining those patients able to take PQ safely. The CareStart G6PD test holds much value for screening malaria patients to determine eligibility for PQ therapy. © The American Society of Tropical Medicine and Hygiene.

Geochemistry of impact glasses from the K/T boundary in Haiti - Relation to smectites and a new type of glass

NASA Technical Reports Server (NTRS)

Koeberl, Christian; Sigurdsson, Haraldur

1992-01-01

Detailed element analyses were carried out on 12 black and seven yellow glasses from the K/T boundary section at Beloc (Haiti), and of three samples from smectite mantles around black glasses. The results obtained for bulk black and yellow glasses show differences between these, confirming the results of Sigurdsson et al. (1991) and Izett (1991), and the results obtained on individual spherules and shards are in agreement with bulk data. The present data also demonstrate, for the first time, the existence of yellow glass samples with high CaO but low S contents, which might have formed by fusion of various proportions of carbonates and evaporites or carbonates alone. One of the black glasses was found to have higher than average SiO2 and K2O abundances but lower concentrations of all other major elements. This suggests the existence of a third glass type, named the high Si-K variety (HSi,K) glass.

Water-Related Infrastructure in a Region of Post-Earthquake Haiti: High Levels of Fecal Contamination and Need for Ongoing Monitoring

PubMed Central

Widmer, Jocelyn M.; Weppelmann, Thomas A.; Alam, Meer T.; Morrissey, B. David; Redden, Edsel; Rashid, Mohammed H.; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K.; Johnson, Judith A.; Morris, J. Glenn

2014-01-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km2) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. PMID:25071005

Site effects in the city of Port au Prince (Haiti) : A combined use of spectral ratio methods and empirical Greens functions simulations

NASA Astrophysics Data System (ADS)

St Fleur, S.; Courboulex, F.; Bertrand, E.; Deschamps, A.; Mercier de Lepinay, B.; Prepetit, C.; Hough, S. E.

2013-12-01

Haiti was struck in January 2010 by a strong Mw=7 earthquake that caused extensive damages in the city of Port au Prince. At this time, very few seismological stations were working in Haiti and the only one that recorded the mainshock in Port au Prince was saturated. Thus, there were no direct measurements of the ground motion produced by this large event. Quickly after the 2010 event, several permanent accelerometric stations were installed by the USGS (U.S. Geological Survey) and the BME (Bureau des Mines et de l'Energie d'Haiti) as well as broad-band stations by the GSC (Geological Survey of Canada). Since their installation, these stations recorded several tens of aftershocks. The aim of our work is to take advantage of this new dataset to better understand the ground motions generated by earthquakes in the city of Port au Prince. We have used first spectral ratio methods to obtain the transfer function of each station, and then an empirical Green's Function simulation approach to combine source and site effects. In order to estimate site effects under each station, we have used classical spectral ratio methods. In a first step, the H/V (Horizontal/Vertical) method was used to select a reference station (in Port au Prince) that should be ideally a station without any site effects. We selected two stations, HCEA and PAPH, as reference stations, as even if the shape of their H/V curves is not always equal to 1 in the entire frequency band. In a second step, we computed the transfer function at each station by a ratio between the spectra of each earthquake at each station and the spectra obtained at the reference station (we use successively HCEA, PAPH and a combination of both). The results were kept only for the frequencies where the signal to noise was larger than 3. In the frequency range 1 to 20 Hz, we found site/reference ratios that reach values from 3 to 8 and a large variability from one station to another one. In the low frequency band 0.5 to 1 Hz a peak

Health equity issues at the local level: socio-geography, access, and health outcomes in the service area of the Hôpital Albert Schweitzer-Haiti.

PubMed

Perry, Henry B; King-Schultz, Leslie W; Aftab, Asma S; Bryant, John H

2007-08-01

Although health equity issues at regional, national and international levels are receiving increasing attention, health equity issues at the local level have been virtually overlooked. Here, we describe here a comprehensive equity assessment carried out by the Hôpital Albert Schweitzer-Haiti (HAS) in 2003. HAS has been operating health and development programs in the Artibonite Valley of Haiti for 50 years. We reviewed all available information arising from a comprehensive evaluation of the programs of HAS carried out in 1999 and 2000. As part of this evaluation, two demographic and health surveys were carried out. We carried out exit interviews with clients receiving primary health care, observations within health facilities, interviews with households related to quality of care, and focus group discussions with community-based health workers. A special study was carried out in 2003 to assess factors determining the use of prenatal care services. Finally, selected findings were obtained from the HAS information system. We found markedly reduced access to health services in the peripheral mountainous areas compared to the central plains. The quality of services was more deficient and the coverage of key services was lower in the mountains. Finally, health status, as measured by under-five mortality rates and levels of childhood malnutrition, was also worse in the mountains. These findings indicate that local health programs need to give attention to monitoring the health status as well as the quality and coverage of basic services among marginalized groups within the program service area. Health inequities will not be overcome until such monitoring occurs and leaders of health programs ensure that inequities identified are addressed in the local programming of activities. It is quite likely that, within relatively small geographic areas in resource-poor settings around the world, similar, if not even greater, levels of health inequities exist. These inequities

Perceptions of Health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012

PubMed Central

Williams, Holly Ann; Gaines, Joanna; Patrick, Molly; Berendes, David; Fitter, David; Handzel, Thomas

2015-01-01

The international response to Haiti’s ongoing cholera outbreak has been multifaceted, including health education efforts by community health workers and the distribution of free water treatment products. Artibonite Department was the first region affected by the outbreak. Numerous organizations have been involved in cholera response efforts in Haiti with many focusing on efforts to improve water, sanitation, and hygiene (WASH). Multiple types of water treatment products have been distributed, creating the potential for confusion over correct dosage and water treatment methods. We utilized qualitative methods in Artibonite to determine the population’s response to WASH messages, use and acceptability of water treatment products, and water treatment and sanitation knowledge, attitudes and practices at the household level. We conducted eighteen focus group discussions (FGDs): 17 FGDs were held with community members (nine among females, eight among males); one FGD was held with community health workers. Health messages related to WASH were well-retained, with reported improvements in hand-washing. Community health workers were identified as valued sources of health information. Most participants noted a paucity of water-treatment products. Sanitation, specifically the construction of latrines, was the most commonly identified need. Lack of funds was the primary reason given for not constructing a latrine. The construction and maintenance of potable water and sanitation services is needed to ensure a sustainable change. PMID:26562658

The roles, barriers and experiences of rehabilitation therapists in disaster relief: post-earthquake Haiti 2010.

PubMed

Klappa, Susan; Audette, Jennifer; Do, Sandy

2014-01-01

This article describes the roles and experiences of rehabilitation therapists involved in disaster relief work (DRW) in Haiti after the 2010 earthquake. The results of a pilot study and phenomenological study are presented. A phenomenological study of rehabilitation providers' experiences in post-disaster relief care is presented along with preliminary pilot study results. The phenomenological study explored the experiences of therapists from a lived experience perspective through the roles they played in DRW. Participants provided disaster relief through direct patient care, adaptive equipment sourcing and allocation, education and training, community outreach and logistic or administrative duties. Barriers and challenges included: (1) emotions: ups and downs; (2) challenges: working at the edge of practice; (3) education: key to success and sustainability; (4) lessons learned: social responsibility is why we go; and (5) difficulty coming home: no one understands. Therapists play a key role in disaster relief situations. Data presented should encourage organizations to include therapists from early planning to implementation of relief services. Further studies are needed to evaluate the impact of rehabilitation interventions in disaster settings. Understanding the roles and experiences of therapists in disaster relief setting is important Certain barriers to providing care in post-disaster settings exist Those participating in disaster response should be well prepared and aware of that they might be asked to do.

Sedimentary Signatures of Submarine Earthquakes: Deciphering the Extent of Sediment Remobilization from the 2011 Tohoku Earthquake and Tsunami and 2010 Haiti Earthquake

NASA Astrophysics Data System (ADS)

McHugh, C. M.; Seeber, L.; Moernaut, J.; Strasser, M.; Kanamatsu, T.; Ikehara, K.; Bopp, R.; Mustaque, S.; Usami, K.; Schwestermann, T.; Kioka, A.; Moore, L. M.

2017-12-01

The 2004 Sumatra-Andaman Mw9.3 and the 2011 Tohoku (Japan) Mw9.0 earthquakes and tsunamis were huge geological events with major societal consequences. Both were along subduction boundaries and ruptured portions of these boundaries that had been deemed incapable of such events. Submarine strike-slip earthquakes, such as the 2010 Mw7.0 in Haiti, are smaller but may be closer to population centers and can be similarly catastrophic. Both classes of earthquakes remobilize sediment and leave distinct signatures in the geologic record by a wide range of processes that depends on both environment and earthquake characteristics. Understanding them has the potential of greatly expanding the record of past earthquakes, which is critical for geohazard analysis. Recent events offer precious ground truth about the earthquakes and short-lived radioisotopes offer invaluable tools to identify sediments they remobilized. In the 2011 Mw9 Japan earthquake they document the spatial extent of remobilized sediment from water depths of 626m in the forearc slope to trench depths of 8000m. Subbottom profiles, multibeam bathymetry and 40 piston cores collected by the R/V Natsushima and R/V Sonne expeditions to the Japan Trench document multiple turbidites and high-density flows. Core tops enriched in xs210Pb,137Cs and 134Cs reveal sediment deposited by the 2011 Tohoku earthquake and tsunami. The thickest deposits (2m) were documented on a mid-slope terrace and trench (4000-8000m). Sediment was deposited on some terraces (600-3000m), but shed from the steep forearc slope (3000-4000m). The 2010 Haiti mainshock ruptured along the southern flank of Canal du Sud and triggered multiple nearshore sediment failures, generated turbidity currents and stirred fine sediment into suspension throughout this basin. A tsunami was modeled to stem from both sediment failures and tectonics. Remobilized sediment was tracked with short-lived radioisotopes from the nearshore, slope, in fault basins including the

Task sharing in rural Haiti: Qualitative assessment of a brief, structured training with and without apprenticeship supervision for community health workers

PubMed Central

McLean, Kristen E; Kaiser, Bonnie N; Hagaman, Ashley K; Wagenaar, Bradley H; Therosme, Tatiana P; Kohrt, Brandon A

2015-01-01

Despite growing support for supervision after task sharing trainings in humanitarian settings, there is limited research on the experience of trainees in apprenticeship and other supervision approaches. Studying apprenticeships from trainees’ perspectives is crucial to refine supervision and enhance motivation for service implementation. The authors implemented a multi-stage, transcultural adaptation for a pilot task sharing training in Haiti entailing three phases: 1) literature review and qualitative research to adapt a mental health and psychosocial support training; 2) implementation and qualitative process evaluation of a brief, structured group training; and 3) implementation and qualitative evaluation of an apprenticeship training, including a two year follow-up of trainees. Structured group training revealed limited knowledge acquisition, low motivation, time and resource constraints on mastery, and limited incorporation of skills into practice. Adding an apprenticeship component was associated with subjective clinical competency, increased confidence regarding utilising skills, and career advancement. Qualitative findings support the added value of apprenticeship according to trainees. PMID:26190953

Patient attrition from the HIV antiretroviral therapy program at two hospitals in Haiti.

PubMed

Puttkammer, Nancy H; Zeliadt, Steven B; Baseman, Janet G; Destiné, Rodney; Wysler Domerçant, Jean; Labbé Coq, Nancy Rachel; Atwood Raphael, Nernst; Sherr, Kenneth; Tegger, Mary; Yuhas, Krista; Barnhart, Scott

2014-10-01

To identify factors associated with antiretroviral therapy (ART) attrition among patients initiating therapy in 2005-2011 at two large, public-sector department-level hospitals, and to inform interventions to improve ART retention. This retrospective cohort study used data from the iSanté electronic medical record (EMR) system. The study characterized ART attrition levels and explored the patient demographic, clinical, temporal, and service utilization factors associated with ART attrition, using time-to-event analysis methods. Among the 2 023 patients in the study, ART attrition on average was 17.0 per 100 person-years (95% confidence interval (CI): 15.8-18.3). In adjusted analyses, risk of ART attrition was up to 89% higher for patients living in distant communes compared to patients living in the same commune as the hospital (hazard ratio: 1.89, 95%CI: 1.54-2.33; P < 0.001). Hospital site, earlier year of ART start, spending less time enrolled in HIV care prior to ART initiation, receiving a non-standard ART regimen, lacking counseling prior to ART initiation, and having a higher body mass index were also associated with attrition risk. The findings suggest quality improvement interventions at the two hospitals, including: enhanced retention support and transportation subsidies for patients accessing care from remote areas; counseling for all patients prior to ART initiation; timely outreach to patients who miss ART pick-ups; "bridging services" for patients transferring care to alternative facilities; routine screening for anticipated interruptions in future ART pick-ups; and medical case review for patients placed on non-standard ART regimens. The findings are also relevant for policymaking on decentralization of ART services in Haiti.

Treatment outcomes after implementation of an adapted WHO protocol for severe sepsis and septic shock in Haiti.

PubMed

Papali, Alfred; Eoin West, T; Verceles, Avelino C; Augustin, Marc E; Nathalie Colas, L; Jean-Francois, Carl H; Patel, Devang M; Todd, Nevins W; McCurdy, Michael T

2017-10-01

The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. Using a before-and-after study design, we retrospectively enrolled 99 adult Emergency Department patients with severe sepsis from January through March 2012. After protocol implementation in January 2014, we compared outcomes to 67 patients with severe sepsis retrospectively enrolled from February to April 2014. We defined sepsis according to the WHO's Integrated Management of Adult Illness guidelines and severe sepsis as sepsis plus organ dysfunction. After protocol implementation, quantity of fluid administered increased and the physician's differential diagnoses more often included sepsis. Patients were more likely to have follow-up vital signs taken sooner, a radiograph performed, and a lactic acid tested. There were no improvements in mortality, time to fluids or antimicrobials. Use of a simplified sepsis protocol based primarily on physiologic parameters allows for substantial improvements in process measures in the care of severely septic patients in a resource-constrained setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Dengue Virus Infections among Haitian and Expatriate Non-governmental Organization Workers — Léogane and Port-au-Prince, Haiti, 2012

PubMed Central

Salyer, Stephanie J.; Ellis, Esther M.; Salomon, Corvil; Bron, Christophe; Juin, Stanley; Hemme, Ryan R.; Hunsperger, Elizabeth; Jentes, Emily S.; Magloire, Roc; Tomashek, Kay M.; Desormeaux, Anne Marie; Muñoz-Jordán, Jorge L.; Etienne, Lesly; Beltran, Manuela; Sharp, Tyler M.; Moffett, Daphne; Tappero, Jordan; Margolis, Harold S.; Katz, Mark A.

2014-01-01

In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves. PMID:25356592

Water-related infrastructure in a region of post-earthquake Haiti: high levels of fecal contamination and need for ongoing monitoring.

PubMed

Widmer, Jocelyn M; Weppelmann, Thomas A; Alam, Meer T; Morrissey, B David; Redden, Edsel; Rashid, Mohammed H; Diamond, Ulrica; Ali, Afsar; De Rochars, Madsen Beau; Blackburn, Jason K; Johnson, Judith A; Morris, J Glenn

2014-10-01

We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km(2)) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water. © The American Society of Tropical Medicine and Hygiene.

Adapting the Caesium-137 technique to document soil redistribution rates associated with traditional cultivation practices in Haiti.

PubMed

Velasco, H; Astorga, R Torres; Joseph, D; Antoine, J S; Mabit, L; Toloza, A; Dercon, G; Walling, Des E

2018-03-01

Large-scale deforestation, intensive land use and unfavourable rainfall conditions are responsible for significant continuous degradation of the Haitian uplands. To develop soil conservation strategies, simple and cost-effective methods are needed to assess rates of soil loss from farmland in Haiti. The fallout radionuclide caesium-137 ( 137 Cs) provides one such means of documenting medium-term soil redistribution rates. In this contribution, the authors report the first use in Haiti of 137 Cs measurements to document soil redistribution rates and the associated pattern of erosion/sedimentation rates along typical hillslopes within a traditional upland Haitian farming area. The local 137 Cs reference inventory, measured at an adjacent undisturbed flat area, was 670 Bq m -2 (SD = 100 Bq m -2 , CV = 15%, n = 7). Within the study area, where cultivation commenced in 1992 after deforestation, three representative downslope transects were sampled. These were characterized by 137 Cs inventories ranging from 190 to 2200 Bq m -2 . Although, the study area was cultivated by the local farmers, the 137 Cs depth distributions obtained from the area differed markedly from those expected from a cultivated area. They showed little evidence of tillage mixing within the upper part of the soil or, more particularly, of the near-uniform activities normally associated with the plough layer or cultivation horizon. They were very similar to that found at the reference site and were characterized by high 137 Cs activities at the surface and much lower activities at greater depths. This situation is thought to reflect the traditional manual tillage practices which cause limited disturbance and mixing of the upper part of the soil. It precluded the use of the conversion models normally used to estimate soil redistribution rates from 137 Cs measurements on cultivated soils and the Diffusion and Migration conversion model frequently used for uncultivated soils was modified for

Seismic rupture process of the 2010 Haiti Earthquake (Mw7.0) inferred from seismic and SAR data

NASA Astrophysics Data System (ADS)

Santos, Rúben; Caldeira, Bento; Borges, José; Bezzeghoud, Mourad

2013-04-01

On January 12th 2010 at 21:53, the Port-au-Prince - Haiti region was struck by an Mw7 earthquake, the second most deadly of the history. The last seismic significant events in the region occurred in November 1751 and June 1770 [1]. Geodetic and geological studies, previous to the 2010 earthquake [2] have warned to the potential of the destructive seismic events in that region and this event has confirmed those warnings. Some aspects of the source of this earthquake are nonconsensual. There is no agreement in the mechanism of rupture or correlation with the fault that should have it generated [3]. In order to better understand the complexity of this rupture, we combined several techniques and data of different nature. We used teleseismic body-wave and Synthetic Aperture Radar data (SAR) based on the following methodology: 1) analysis of the rupture process directivity [4] to determine the velocity and direction of rupture; 2) teleseismic body-wave inversion to obtain the spatiotemporal fault slip distribution and a detailed rupture model; 3) near field surface deformation modeling using the calculated seismic rupture model and compared with the measured deformation field using SAR data of sensor Advanced Land Observing Satellite - Phased Array L-band SAR (ALOS-PALSAR). The combined application of seismic and geodetic data reveals a complex rupture that spread during approximately 12s mainly from WNW to ESE with average velocity of 2,5km/s, on a north-dipping fault plane. Two main asperities are obtained: the first (and largest) occurs within the first ~ 5sec and extends for approximately 6km around the hypocenter; the second one, that happens in the remaining 6s, covers a near surface rectangular strip with about 12km long by 3km wide. The first asperity is compatible with a left lateral strike-slip motion with a small reverse component; the mechanism of second asperity is predominantly reverse. The obtained rupture process allows modeling a coseismic deformation

Use of Rapid Ascertainment Process for Institutional Deaths (RAPID) to identify pregnancy-related deaths in tertiary-care obstetric hospitals in three departments in Haiti.

PubMed

Boyd, Andrew T; Hulland, Erin N; Grand'Pierre, Reynold; Nesi, Floris; Honoré, Patrice; Jean-Louis, Reginald; Handzel, Endang

2017-05-16

Accurate assessment of maternal deaths is difficult in countries lacking standardized data sources for their review. As a first step to investigate suspected maternal deaths, WHO suggests surveillance of "pregnancy-related deaths", defined as deaths of women while pregnant or within 42 days of termination of pregnancy, irrespective of cause. Rapid Ascertainment Process for Institutional Deaths (RAPID), a surveillance tool, retrospectively identifies pregnancy-related deaths occurring in health facilities that may be missed by routine surveillance to assess gaps in reporting these deaths. We used RAPID to review pregnancy-related deaths in six tertiary obstetric care facilities in three departments in Haiti. We reviewed registers and medical dossiers of deaths among women of reproductive age occurring in 2014 and 2015 from all wards, along with any additional available dossiers of deaths not appearing in registers, to capture pregnancy status, suspected cause of death, and timing of death in relation to the pregnancy. We used capture-recapture analyses to estimate the true number of in-hospital pregnancy-related deaths in these facilities. Among 373 deaths of women of reproductive age, we found 111 pregnancy-related deaths, 25.2% more than were reported through routine surveillance, and 22.5% of which were misclassified as non-pregnancy-related. Hemorrhage (27.0%) and hypertensive disorders (18.0%) were the most common categories of suspected causes of death, and deaths after termination of pregnancy were statistically significantly more common than deaths during pregnancy or delivery. Data were missing at multiple levels: 210 deaths had an undetermined pregnancy status, 48.7% of pregnancy-related deaths lacked specific information about timing of death in relation to the pregnancy, and capture-recapture analyses in three hospitals suggested that approximately one-quarter of pregnancy-related deaths were not captured by RAPID or routine surveillance. Across six

Landslides triggered by the 12 January 2010 Port-au-Prince, Haiti, Mw = 7.0 earthquake: visual interpretation, inventory compiling, and spatial distribution statistical analysis

NASA Astrophysics Data System (ADS)

Xu, C.; Shyu, J. B. H.; Xu, X.

2014-07-01

The 12 January 2010 Port-au-Prince, Haiti, earthquake (Mw= 7.0) triggered tens of thousands of landslides. The purpose of this study is to investigate the correlations of the occurrence of landslides and the thicknesses of their erosion with topographic, geologic, and seismic parameters. A total of 30 828 landslides triggered by the earthquake covered a total area of 15.736 km2, distributed in an area more than 3000 km2, and the volume of landslide accumulation materials is estimated to be about 29 700 000 m3. These landslides are of various types, mostly belonging to shallow disrupted landslides and rock falls, but also include coherent deep-seated landslides and rock slides. These landslides were delineated using pre- and post-earthquake high-resolution satellite images. Spatial distribution maps and contour maps of landslide number density, landslide area percentage, and landslide erosion thickness were constructed in order to analyze the spatial distribution patterns of co-seismic landslides. Statistics of size distribution and morphometric parameters of co-seismic landslides were carried out and were compared with other earthquake events in the world. Four proxies of co-seismic landslide abundance, including landslides centroid number density (LCND), landslide top number density (LTND), landslide area percentage (LAP), and landslide erosion thickness (LET) were used to correlate co-seismic landslides with various environmental parameters. These parameters include elevation, slope angle, slope aspect, slope curvature, topographic position, distance from drainages, lithology, distance from the epicenter, distance from the Enriquillo-Plantain Garden fault, distance along the fault, and peak ground acceleration (PGA). A comparison of these impact parameters on co-seismic landslides shows that slope angle is the strongest impact parameter on co-seismic landslide occurrence. Our co-seismic landslide inventory is much more detailed than other inventories in several

Landslides triggered by the 12 January 2010 Mw 7.0 Port-au-Prince, Haiti, earthquake: visual interpretation, inventory compiling and spatial distribution statistical analysis

NASA Astrophysics Data System (ADS)

Xu, C.; Shyu, J. B. H.; Xu, X.-W.

2014-02-01

The 12 January 2010 Port-au-Prince, Haiti, earthquake (Mw 7.0) triggered tens of thousands of landslides. The purpose of this study is to investigate the correlations of the occurrence of landslides and their erosion thicknesses with topographic factors, seismic parameters, and their distance from roads. A total of 30 828 landslides triggered by the earthquake covered a total area of 15.736 km2, distributed in an area more than 3000 km2, and the volume of landslide accumulation materials is estimated to be about 29 700 000 m3. These landslides are of various types, mostly belonging to shallow disrupted landslides and rock falls, but also include coherent deep-seated landslides and rock slides. These landslides were delineated using pre- and post-earthquake high-resolutions satellite images. Spatial distribution maps and contour maps of landslide number density, landslide area percentage, and landslide erosion thickness were constructed in order to analyze the spatial distribution patterns of co-seismic landslides. Statistics of size distribution and morphometric parameters of co-seismic landslides were carried out and were compared with other earthquake events in the world. Four proxies of co-seismic landslide abundance, including landslides centroid number density (LCND), landslide top number density (LTND), landslide area percentage (LAP), and landslide erosion thickness (LET) were used to correlate co-seismic landslides with various landslide controlling parameters. These controlling parameters include elevation, slope angle, slope aspect, slope curvature, topographic position, distance from drainages, lithology, distance from the epicenter, distance from the Enriquillo-Plantain Garden fault, distance along the fault, and peak ground acceleration (PGA). A comparison of these impact parameters on co-seismic landslides shows that slope angle is the strongest impact parameter on co-seismic landslide occurrence. Our co-seismic landslide inventory is much more

Patient attrition from the HIV antiretroviral therapy program at two hospitals in Haiti

PubMed Central

Puttkammer, Nancy H.; Zeliadt, Steven B.; Baseman, Janet G.; Destiné, Rodney; Domerçant, Jean Wysler; Coq, Nancy Rachel Labbé; Raphael, Nernst Atwood; Sherr, Kenneth; Tegger, Mary; Yuhas, Krista; Barnhart, Scott

2016-01-01

Objective To identify factors associated with antiretroviral therapy (ART) attrition among patients initiating therapy in 2005–2011 at two large, public-sector department-level hospitals, and to inform interventions to improve ART retention. Methods This retrospective cohort study used data from the iSanté electronic medical record (EMR) system. The study characterized ART attrition levels and explored the patient demographic, clinical, temporal, and service utilization factors associated with ART attrition, using time-to-event analysis methods. Results Among the 2 023 patients in the study, ART attrition on average was 17.0 per 100 person-years (95% confidence interval (CI): 15.8–18.3). In adjusted analyses, risk of ART attrition was up to 89% higher for patients living in distant communes compared to patients living in the same commune as the hospital (hazard ratio: 1.89, 95%CI: 1.54–2.33; P < 0.001). Hospital site, earlier year of ART start, spending less time enrolled in HIV care prior to ART initiation, receiving a non-standard ART regimen, lacking counseling prior to ART initiation, and having a higher body mass index were also associated with attrition risk. Conclusions The findings suggest quality improvement interventions at the two hospitals, including: enhanced retention support and transportation subsidies for patients accessing care from remote areas; counseling for all patients prior to ART initiation; timely outreach to patients who miss ART pick-ups; “bridging services” for patients transferring care to alternative facilities; routine screening for anticipated interruptions in future ART pick-ups; and medical case review for patients placed on non-standard ART regimens. The findings are also relevant for policymaking on decentralization of ART services in Haiti. PMID:25563149

Vertical Deformation of Late Quaternary Features Across Port-au-Prince Bay, Haiti

NASA Astrophysics Data System (ADS)

Cormier, M.; McHugh, C. M.; Gulick, S. P.; Braudy, N.; Davis, M. B.; Diebold, J. B.; Dieudonne, N.; Douilly, R.; Hornbach, M. J.; Johnson, H. E.; Mishkin, K.; Seeber, L.; Sorlien, C. C.; Steckler, M. S.; Symithe, S. J.; Templeton, J.

2010-12-01

As part of a project that investigated the underwater impacts of the January 12, 2010 earthquake in Haiti, we surveyed offshore structures that may have been activated during that earthquake or that might become activated in future earthquakes. Part of that survey focused on the shallow shelf area that extends north of the segment of the Enriquillo-Plantain Garden fault that just ruptured. This area is occupied by an elongated depression, 25 km long, 10 km wide, and 140 m deep. The NW-SE axis of that shallow basin is sub-parallel to that of the NW-SE anticlines that bounds Port-au-Prince Bay. The shallow basin is also rimmed by a carbonate platform that is 5-10 km-wide and ~30m deep. New multibeam bathymetric and sidescan sonar data collected across that platform highlight a series of circular dissolution structures 1-2 km across and ~80 m deep. We interpret that morphology to indicate antecedent karst topography that developed during previous glacial maxima. According to that scenario, the shallow basin off Port-au-Prince would have been isolated from the Caribbean Sea by the continuous platform, and would probably have been occupied by a lagoon. Indeed, a few high-resolution chirp profiles image what may be a paleoshoreline at about 80m depth, buried beneath a 5-8 m thick, acoustically transparent, presumably Holocene layer. Preliminary analysis indicates that the basin floor and the base of the presumably Holocene layer are perfectly horizontal in the center of the basin, but tilted down to the south at its northern edge. The presumed paleoshoreline is also shallower to the north of the basin. We propose that this tilt is driven by contraction across the NW-SE fold-and-thrust belt that runs across Hispaniola. This hypothesis remains to be tested with a more thorough geophysical and coring survey in Port-au-Prince Bay.

Development of a Breast Cancer Treatment Program in Port-au-Prince, Haiti: Experiences From the Field

PubMed Central

Libby, Rachel; Patberg, Elizabeth; Gabriel, Dieudina; Al-Quran, Samer; Kasher, Matthew; Heldermon, Coy; Daily, Karen; Auguste, Joseph R.; Suprien, Valery C.; Hurley, Judith

2016-01-01

Purpose The nonprofit Project Medishare launched a breast cancer treatment program in Port-au-Prince in July 2013 to address the demand for breast cancer care in Haiti. We outline the development of the program, highlight specific challenges, and discuss key considerations for others working in global oncology. Methods We reflected on our experiences in the key areas of developing partnerships, building laboratory capacity, conducting medical training, using treatment algorithms, and ensuring access to safe, low-cost chemotherapy drugs. We also critically reviewed our costs and quality measures. Results The program has treated a total of 139 patients with breast cancer with strong adherence to treatment regimens in 85% of patients. In 273 chemotherapy administrations, no serious exposure or adverse safety events were reported by staff. The mortality rate for 94 patients for whom we have complete data was 24% with a median survival time of 53 months. Our outcome data were likely influenced by stage at presentation, with more than half of patients presenting more than 12 months after first noticing a tumor. Future efforts will therefore focus on continuing to improve the level of care, while working with local partners to spread awareness, increase screening, and get more women into care earlier in the course of their disease. Conclusion Our experiences may inform others working to implement protocol-based cancer treatment programs in resource-poor settings and can provide valuable lessons learned for future global oncology efforts. PMID:28717677

Ground-water geology of the Gonaives Plain, Haiti

USGS Publications Warehouse

Taylor, George C.; Lemoine, Rémy C.

1950-01-01

The Gonaives Plain lies in northern Haiti at the head of the Gulf of Gonaives. Ground water in the plain is used widely for domestic and stock purposes but only to limited extent for irrigation. The future agricultural development of the plain will depend in large measure on the proper utilization of available ground-water supplies for irrigation. The rocks in the region of the Gonaives Plain belong to the upper (?) Cretaceous series of the Cretaceous system, the Nocene and Oligovene series of the Tertiary system, and the Pleistocene and Recent series of the Quarternary system. The structural depression occupied by the Gonaives Plain was formed in post-Miocene time by the dislocation of Oligocene and older rocks along normal faults and by the tilting of the adjacent crustal blocks. The lower parts of the depression contain a Pleistocene and Recent alluvial fill deposited by streams tributary to the plain. The upper (?) Cretaceous rocks include aniesite and basalt lava flows locally intercalated with some beds of tuff and agglomerate. These rocks are generally dense and impervious but locally small springs rise from fractures and bedding planes or from weathered zones. The Nocene rocks are hard, thin-bedded, cherty limestones with some beds of massive chalky limestone. Considerable ground water circulates through joints, bedding planes, and solution passages in these rocks giving rise to important springs such as Sources Madame Charles. These springs discharge at the rate of about 110 liters per second. The Oligocene rocks include limestone, shely limestone, limy sandstone, marl, and shale. The limestone beds contain solution passages and other openings and these may afford capacity for the circulation of ground water. However, no wells or springs in Oligocene rocks were observed during the present study. The alluvial fill of the plain is composed of interbedded lenses of clay, silt, sand, and gravel. These deposits contain a zone of saturation whose upper limit is

Handheld solar light use, durability, and retention among women and girls in internally displaced persons camps in Haiti - 2013-2014.

PubMed

Dynes, Michelle; Rosenthal, Mariana; Hulland, Erin; Hardy, Colleen; Torre, Lisandro; Tomczyk, Barbara

2016-09-01

During conflict and disasters, women and girls are at increased risk of gender based violence. International humanitarian guidelines call for the distribution of individual lighting to meet women and girls' basic needs and to reduce risk of violence; however, little evidence exists to support these guidelines. This paper presents an evaluation of handheld solar light use, retention, and durability among women and girls living in two internally displaced persons camps in Port-au-Prince, Haiti. Data was gathered prospectively via five household surveys from August 2013 to April 2014; a total of 754 females participated in the study. Women reported going outside at night more frequently at the end of the study than at the beginning. The handheld solar lights were the most common source of lighting at endline, whereas candle and gas lamp use declined significantly over time. Results from a Life-Table survival analysis estimated that households had an 83% probability of still owning a functioning light after seven months. Given the frequent use, acceptable durability, and retention of the lights, donors and humanitarian organizations should consider supporting light distribution to women and girls in internally displaced persons camps to help meet their basic needs.

Ti Foyer (Hearth) community-based nutrition activities informed by the positive deviance approach in Leogane, Haiti: a programmatic description.

PubMed

Bolles, Kathryn; Speraw, Catherine; Berggren, Gretchen; Lafontant, Jack Guy

2002-12-01

This paper details the steps to design and implement a positive deviance-informed, "Hearth" approach for the nutritional rehabilitation of malnourished children in the district of Leogane, Haiti. Groups of four to five children met daily for two weeks at the home of a local volunteer mother for nutritional and health messages and a well-balanced meal. Health messages and meal components were determined using information gathered from interviews with the mothers of positive deviant children in the community who are well nourished despite their family's limited economic resources. Hearth participants were then followed for six months in their own home by the program "monitrices," women hired from each village and intensively trained to supervise the Hearth program, periodically weigh the children to evaluate their progress, and liaise between the hospital and the community. Monitoring from the first cycle indicated that 100% of children in eight villages and 66% of children in the remaining five villages continued to gain weight as fast or faster than the international standard median six months after participating in a Hearth program. At the conclusion of this cycle, programmers interviewed participant and non-participant families and made six modifications to the model, including the addition of a microcredit option for participating mothers.

The use and performance of BioSand filters in the Artibonite Valley of Haiti: a field study of 107 households.

PubMed

Duke, W F; Nordin, R N; Baker, D; Mazumder, A

2006-01-01

Approximately one billion people world-wide lack access to adequate amounts of safe water. Most are in developing countries, especially in rapidly expanding urban fringes, poor rural areas, and indigenous communities. In February and March 2005, a field study of 107 households was conducted to evaluate the use and performance of the Manz BioSand filter in the Artibonite Valley of Haiti. Approximately 2000 filters had been installed in this area over the preceding 5 years by the staff in Community Development at Hospital Albert Schweitzer, Deschappelle, Haiti. Interviews, observations, and water samplings were carried-out by two teams of Haitian enumerators, each consisting of a nurse and a filter technician. Water analyses were performed by Haitian lab technicians using the membrane filtration method to determine Escherichia coli counts. The enumerators and the lab technicians completed a 2 week training program before beginning the study; they worked under the direct supervision of the primary investigator. Laboratory quality was monitored by running 10% blank and 10% duplicate samples. The households contained an average of 5.4 persons. Filters had been in use for an average of 2.5 years, and participants were generally satisfied with their filter's performance. Shallow, hand-dug wells provided the only source of water for 61% of the households, with 26% using water piped from springs or deep wells, and 13% having access to both. Only 3% had plumbing in their homes. Source water from shallow wells contained an average of 234 E. coli cfu/100 mL. Piped sources averaged 195 E. coli cfu/100 mL. Of the source water samples 26% contained 0-10 E. coli cfu/100 mL. Of the filtered water samples 97% contained 0-10 E. coli cfu/100 mL (80% with 0 cfu/100 mL, and 17% with 1-10 cfu/100 mL). Overall bacterial removal efficiency for the filters was calculated to be 98.5%. Turbidity decreased from an average of 6.2 NTU in source water samples to 0.9 NTU in the filtered water

A spatially explicit model for the future progression of the current Haiti cholera epidemic

NASA Astrophysics Data System (ADS)

Bertuzzo, E.; Mari, L.; Righetto, L.; Gatto, M.; Casagrandi, R.; Rodriguez-Iturbe, I.; Rinaldo, A.

2011-12-01

As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to July 2011, climb to 385,000 cases and 5,800 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of textit{Vibrio cholera}, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan texttrademark project). The model directly account for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations, clean water supply and educational campaigns, thus emerging as an essential component of the control of future cholera

Child protection assessment in humanitarian emergencies: case studies from Georgia, Gaza, Haiti and Yemen.

PubMed

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-12-01

The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective

Spatio-Temporal Dynamics of Cholera during the First Year of the Epidemic in Haiti

PubMed Central

Gaudart, Jean; Rebaudet, Stanislas; Barrais, Robert; Boncy, Jacques; Faucher, Benoit; Piarroux, Martine; Magloire, Roc; Thimothe, Gabriel; Piarroux, Renaud

2013-01-01

Background In October 2010, cholera importation in Haiti triggered an epidemic that rapidly proved to be the world's largest epidemic of the seventh cholera pandemic. To establish effective control and elimination policies, strategies rely on the analysis of cholera dynamics. In this report, we describe the spatio-temporal dynamics of cholera and the associated environmental factors. Methodology/Principal findings Cholera-associated morbidity and mortality data were prospectively collected at the commune level according to the World Health Organization standard definition. Attack and mortality rates were estimated and mapped to assess epidemic clusters and trends. The relationships between environmental factors were assessed at the commune level using multivariate analysis. The global attack and mortality rates were 488.9 cases/10,000 inhabitants and 6.24 deaths/10,000 inhabitants, respectively. Attack rates displayed a significantly high level of spatial heterogeneity (varying from 64.7 to 3070.9 per 10,000 inhabitants), thereby suggesting disparate outbreak processes. The epidemic course exhibited two principal outbreaks. The first outbreak (October 16, 2010–January 30, 2011) displayed a centrifugal spread of a damping wave that suddenly emerged from Mirebalais. The second outbreak began at the end of May 2011, concomitant with the onset of the rainy season, and displayed a highly fragmented epidemic pattern. Environmental factors (river and rice fields: p<0.003) played a role in disease dynamics exclusively during the early phases of the epidemic. Conclusion Our findings demonstrate that the epidemic is still evolving, with a changing transmission pattern as time passes. Such an evolution could have hardly been anticipated, especially in a country struck by cholera for the first time. These results argue for the need for control measures involving intense efforts in rapid and exhaustive case tracking. PMID:23593516

Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti

PubMed Central

Surkan, Pamela J.; Mukherjee, Joia S.; Williams, David R.; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C.; Oswald, Catherine M.; Fawzi, Mary C. Smith

2010-01-01

In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10–17 years was conducted in 2006–2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level. PMID:20635244

The Challenges of Establishing and Sustaining an Overseas Enterprise: One Haitian NGO's Perspective.

PubMed

Greig, Elizabeth; Cornely, Cheryl Clark; Green, Barth A

2015-06-01

This article describes the creation of Project Medishare for Haiti, Inc, a US 501(c)3 nonprofit organization and its counterpart in Haiti, Project Medishare in Haiti, a nongovernmental organization that provides health care resources and training and education in Haiti. It summarizes the strategy for fundraising and sustaining such an enterprise in a developing country and discusses the lessons learned and goals achieved during the last 20 years.

Cryptosporidiosis in Haiti: surprisingly low level of species diversity revealed by molecular characterization of Cryptosporidium oocysts from surface water and groundwater

PubMed Central

Damiani, Céline; Balthazard-Accou, Ketty; Clervil, Elmyre; Diallo, Aïssata; Da Costa, Cécilia; Emmanuel, Evens; Totet, Anne; Agnamey, Patrice

2013-01-01

The protozoan parasite Cryptosporidium sp. has emerged as one of the most important water contaminants, causing waterborne outbreaks of diarrhoeal diseases worldwide. In Haiti, cryptosporidiosis is a frequent cause of diarrhoea in children under the age of five years, HIV-infected individuals, and people living in low socioeconomic conditions, mainly due to the consumption of water or food polluted by Cryptosporidium oocysts. The aim of this study was to detect and identify Cryptosporidium oocysts present in 12 water samples collected in Port-au-Prince and 4 water samples collected in Cap Haïtien. Initial detection consisted of immunomagnetic separation – immunofluorescence assay (IMS-IFA), which was confirmed by nested PCR, targeting the most polymorphic region of the 18S rRNA gene in 15/16 samples. Genotyping was performed by PCR-restriction fragment length polymorphism (RFLP) analysis and DNA sequencing. Under our working conditions, neither nested PCR-RFLP nor direct DNA sequencing revealed the expected species diversity, as only Cryptosporidium parvum was identified in the water samples studied. This study highlights the difficulty of detecting mixed populations of Cryptosporidium species in environmental samples. PMID:24252814

Economic determinants of breastfeeding in Haiti: The effects of poverty, food insecurity, and employment on exclusive breastfeeding in an urban population.

PubMed

Lesorogol, Carolyn; Bond, Caitlin; Dulience, Sherlie Jean Louis; Iannotti, Lora

2018-04-01

There is limited and inconsistent empirical evidence regarding the role of economic factors in breastfeeding practices, globally. Studies have found both negative and positive associations between low income and exclusive breastfeeding (EBF). Employment, which should improve household income, may reduce EBF due to separation of mother and infant. In the context of a randomized controlled study of lipid-based complementary feeding in an urban slum in Cap Haitien, Haiti, we examined the economic factors influencing breastfeeding practices using mixed methods. Findings demonstrate relationships between urban context, economic factors, and breastfeeding practices. Poverty, food insecurity, time constraints, and limited social support create challenges for EBF. Maternal employment is associated with lower rates of EBF and less frequent breastfeeding. Extreme food insecurity sometimes leads to increased exclusive breastfeeding among Haitian mothers, what we call "last resort EBF." In this case, women practice EBF because they have no alternative food source for the infant. Suggested policies and programs to address economic constraints and promote EBF in this population include maternal and child allowances, quality child care options, and small-scale household urban food production. © 2017 John Wiley & Sons Ltd.

Influence of transportation cost on long-term retention in clinic for HIV patients in rural Haiti.

PubMed

Sowah, Leonard A; Turenne, Franck V; Buchwald, Ulrike K; Delva, Guesly; Mesidor, Romaine N; Dessaigne, Camille G; Previl, Harold; Patel, Devang; Edozien, Anthony; Redfield, Robert R; Amoroso, Anthony

2014-12-01

With improved access to antiretroviral therapy in resource-constrained settings, long-term retention in HIV clinics has become an important means of reducing costs and improving outcomes. Published data on retention in HIV clinics beyond 24 months are, however, limited. In our clinic in rural Haiti, we hypothesized that individuals residing in locations with higher transportation costs to clinic would have poorer retention than those who had lower costs. We used a retrospective cohort design to evaluate potential predictors of HIV clinic retention. Patient information was abstracted from the electronic medical records. Cox proportional hazards regression was used to identify independent predictors of 4-year clinic retention. There were 410 patients in our cohort, 266 (64.9%) females and 144 (35.1%) males. Forty-five (11%) patients lived in locations with transportation costs >$2. Males were 1.5 times more likely to live in municipalities with transportation costs to clinic of >$2. Multivariate analysis suggested that age <30 years, male gender, and transportation cost were independent predictors of loss to follow-up (LTFU): risk ratio of 2.98, 95% confidence interval (CI): 1.73 to 4.96, P < 0.001; 1.71, CI: 1.08 to 2.70, P = 0.02; and 1.91, CI: 1.08 to 3.36, P = 0.02, respectively. Patients with transportation costs greater than $2 were 1.9 times more likely to be lost to care compared with those who paid less for transportation. HIV treatment programs in resource-constrained settings may need to pay closer attention to issues related to transportation cost to improve patient retention.

A mobile clinic approach to the delivery of community-based mental health services in rural Haiti.

PubMed

Fils-Aimé, J Reginald; Grelotti, David J; Thérosmé, Tatiana; Kaiser, Bonnie N; Raviola, Giuseppe; Alcindor, Yoldie; Severe, Jennifer; Affricot, Emmeline; Boyd, Katherine; Legha, Rupinder; Daimyo, Shin; Engel, Stephanie; Eustache, Eddy

2018-01-01

This study evaluates the use of a mental health mobile clinic to overcome two major challenges to the provision of mental healthcare in resource-limited settings: the shortage of trained specialists; and the need to improve access to safe, effective, and culturally sound care in community settings. Employing task-shifting and supervision, mental healthcare was largely delivered by trained, non-specialist health workers instead of specialists. A retrospective chart review of 318 unduplicated patients assessed and treated during the mobile clinic's first two years (January 2012 to November 2013) was conducted to explore outcomes. These data were supplemented by a quality improvement questionnaire, illustrative case reports, and a qualitative interview with the mobile clinic's lead community health worker. The team evaluated an average of 42 patients per clinic session. The most common mental, neurological, or substance abuse (MNS) disorders were depression and epilepsy. Higher follow-up rates were seen among those with diagnoses of bipolar disorder and neurological conditions, while those with depression or anxiety had lower follow-up rates. Persons with mood disorders who were evaluated on at least two separate occasions using a locally developed depression screening tool experienced a significant reduction in depressive symptoms. The mental health mobile clinic successfully treated a wide range of MNS disorders in rural Haiti and provided care to individuals who previously had no consistent access to mental healthcare. Efforts to address these common barriers to the provision of mental healthcare in resource-limited settings should consider supplementing clinic-based with mobile services.

An epidemic model for the future progression of the current Haiti cholera epidemic

NASA Astrophysics Data System (ADS)

Bertuzzo, E.; Mari, L.; Righetto, L.; Casagrandi, R.; Gatto, M.; Rodriguez-Iturbe, I.; Rinaldo, A.

2012-04-01

As a major cholera epidemic progresses in Haiti, and the figures of the infection, up to December 2011, climb to 522,000 cases and 7,000 deaths, the development of general models to track and predict the evolution of the outbreak, so as to guide the allocation of medical supplies and staff, is gaining notable urgency. We propose here a spatially explicit epidemic model that accounts for the dynamics of susceptible and infected individuals as well as the redistribution of Vibrio cholera, the causative agent of the disease, among different human communities. In particular, we model two spreading pathways: the advection of pathogens through hydrologic connections and the dissemination due to human mobility described by means of a gravity-like model. To this end the country has been divided into hydrologic units based on drainage directions derived from a digital terrain model. Moreover the population of each unit has been estimated from census data downscaled to 1 km x 1 km resolution via remotely sensed geomorphological information (LandScan project). The model directly accounts for the role of rainfall patterns in driving the seasonality of cholera outbreaks. The two main outbreaks in fact occurred during the rainy seasons (October and May) when extensive floodings severely worsened the sanitation conditions and, in turn, raised the risk of infection. The model capability to reproduce the spatiotemporal features of the epidemic up to date grants robustness to the foreseen future development. To this end, we generate realistic scenario of future precipitation in order to forecast possible epidemic paths up to the end of the 2013. In this context, the duration of acquired immunity, a hotly debated topic in the scientific community, emerges as a controlling factor for progression of the epidemic in the near future. The framework presented here can straightforwardly be used to evaluate the effectiveness of alternative intervention strategies like mass vaccinations

Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew

PubMed Central

Camacho, Anton; Grandesso, Francesco; Cohuet, Sandra; Lemaitre, Joseph C.; Rinaldo, Andrea

2018-01-01

Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign. A rainfall-driven, spatially-explicit meta-community model of cholera transmission was coupled to a data assimilation scheme for computing short-term projections of the epidemic in near real-time. The model was used to forecast cholera incidence for the months after the passage of the hurricane (October-December 2016) and to predict the impact of a planned oral cholera vaccination campaign. Our first projection, from October 29 to December 31, predicted the highest incidence in the departments of Grande Anse and Sud, accounting for about 45% of the total cases in Haiti. The projection included a second peak in cholera incidence in early December largely driven by heavy rainfall forecasts, confirming the urgency for rapid intervention. A second projection (from November 12 to December 31) used updated rainfall forecasts to estimate that 835 cases would be averted by vaccinations in Grande Anse (90% Prediction Interval [PI] 476-1284) and 995 in Sud (90% PI 508-2043). The experience gained by this modeling effort shows that state-of-the-art computational modeling and data-assimilation methods can produce informative near real-time projections of cholera incidence. Collaboration among modelers and field epidemiologists is indispensable to gain fast access to field data and to translate model results into operational recommendations for emergency management during an outbreak. Future efforts should thus draw together multi

Near real-time forecasting for cholera decision making in Haiti after Hurricane Matthew.

PubMed

Pasetto, Damiano; Finger, Flavio; Camacho, Anton; Grandesso, Francesco; Cohuet, Sandra; Lemaitre, Joseph C; Azman, Andrew S; Luquero, Francisco J; Bertuzzo, Enrico; Rinaldo, Andrea

2018-05-01

Computational models of cholera transmission can provide objective insights into the course of an ongoing epidemic and aid decision making on allocation of health care resources. However, models are typically designed, calibrated and interpreted post-hoc. Here, we report the efforts of a team from academia, field research and humanitarian organizations to model in near real-time the Haitian cholera outbreak after Hurricane Matthew in October 2016, to assess risk and to quantitatively estimate the efficacy of a then ongoing vaccination campaign. A rainfall-driven, spatially-explicit meta-community model of cholera transmission was coupled to a data assimilation scheme for computing short-term projections of the epidemic in near real-time. The model was used to forecast cholera incidence for the months after the passage of the hurricane (October-December 2016) and to predict the impact of a planned oral cholera vaccination campaign. Our first projection, from October 29 to December 31, predicted the highest incidence in the departments of Grande Anse and Sud, accounting for about 45% of the total cases in Haiti. The projection included a second peak in cholera incidence in early December largely driven by heavy rainfall forecasts, confirming the urgency for rapid intervention. A second projection (from November 12 to December 31) used updated rainfall forecasts to estimate that 835 cases would be averted by vaccinations in Grande Anse (90% Prediction Interval [PI] 476-1284) and 995 in Sud (90% PI 508-2043). The experience gained by this modeling effort shows that state-of-the-art computational modeling and data-assimilation methods can produce informative near real-time projections of cholera incidence. Collaboration among modelers and field epidemiologists is indispensable to gain fast access to field data and to translate model results into operational recommendations for emergency management during an outbreak. Future efforts should thus draw together multi

Earthquake damage mapping by using remotely sensed data: the Haiti case study

NASA Astrophysics Data System (ADS)

Romaniello, Vito; Piscini, Alessandro; Bignami, Christian; Anniballe, Roberta; Stramondo, Salvatore

2017-01-01

This work proposes methodologies aimed at evaluating the sensitivity of optical and synthetic aperture radar (SAR) change features obtained from satellite images with respect to the damage grade due to an earthquake. The test case is the Mw 7.0 earthquake that hit Haiti on January 12, 2010, located 25 km west-south-west of the city of Port-au-Prince. The disastrous shock caused the collapse of a huge number of buildings and widespread damage. The objective is to investigate possible parameters that can affect the robustness and sensitivity of the proposed methods derived from the literature. It is worth noting how the proposed analysis concerns the estimation of derived features at object scale. For this purpose, a segmentation of the study area into several regions has been done by considering a set of polygons, over the city of Port-au-Prince, extracted from the open source open street map geo-database. The analysis of change detection indicators is based on ground truth information collected during a postearthquake survey and is available from a Joint Research Centre database. The resulting damage map is expressed in terms of collapse ratio, thus indicating the areas with a greater number of collapsed buildings. The available satellite dataset is composed of optical and SAR images, collected before and after the seismic event. In particular, we used two GeoEye-1 optical images (one preseismic and one postseismic) and three TerraSAR-X SAR images (two preseismic and one postseismic). Previous studies allowed us to identify some features having a good sensitivity with damage at the object scale. Regarding the optical data, we selected the normalized difference index and two quantities coming from the information theory, namely the Kullback-Libler divergence (KLD) and the mutual information (MI). In addition, for the SAR data, we picked out the intensity correlation difference and the KLD parameter. In order to analyze the capability of these parameters to correctly

A new "American" subgroup of African-lineage Chikungunya virus detected in and isolated from mosquitoes collected in Haiti, 2016.

PubMed

White, Sarah Keller; Mavian, Carla; Salemi, Marco; Morris, John Glenn; Elbadry, Maha A; Okech, Bernard A; Lednicky, John A; Dunford, James C

2018-01-01

As part of on-going arboviral surveillance activity in a semi-rural region in Haiti, Chikungunya virus (CHIKV)-positive mosquito pools were identified in 2014 (the peak of the Caribbean Asian-clade epidemic), and again in 2016 by RT-PCR. In 2014, CHIKV was only identified in Aedes aegypti (11 positive pools/124 screened). In contrast, in sampling in 2016, CHIKV was not identified in Ae. aegypti, but, rather, in (a) a female Aedes albopictus pool, and (b) a female Culex quinquefasciatus pool. Genomic sequence analyses indicated that the CHIKV viruses in the 2016 mosquito pools were from the East-Central-South African (ECSA) lineage, rather than the Asian lineage. In phylogenetic studies, these ECSA lineage strains form a new ECSA subgroup (subgroup IIa) together with Brazilian ECSA lineage strains from an isolated human outbreak in 2014, and a mosquito pool in 2016. Additional analyses date the most recent common ancestor of the ECSA IIa subgroup around May 2007, and the 2016 Haitian CHIKV genomes around December 2015. Known CHIKV mutations associated with improved Ae. albopictus vector competence were not identified. Isolation of this newly identified lineage from Ae. albopictus is of concern, as this vector has a broader geographic range than Ae. aegypti, especially in temperate areas of North America, and stresses the importance for continued vector surveillance.

Building and Rebuilding: The National Public Health Laboratory Systems and Services Before and After the Earthquake and Cholera Epidemic, Haiti, 2009-2015.

PubMed

Jean Louis, Frantz; Buteau, Josiane; Boncy, Jacques; Anselme, Renette; Stanislas, Magalie; Nagel, Mary C; Juin, Stanley; Charles, Macarthur; Burris, Robert; Antoine, Eva; Yang, Chunfu; Kalou, Mireille; Vertefeuille, John; Marston, Barbara J; Lowrance, David W; Deyde, Varough

2017-10-01

Before the 2010 devastating earthquake and cholera outbreak, Haiti's public health laboratory systems were weak and services were limited. There was no national laboratory strategic plan and only minimal coordination across the laboratory network. Laboratory capacity was further weakened by the destruction of over 25 laboratories and testing sites at the departmental and peripheral levels and the loss of life among the laboratory health-care workers. However, since 2010, tremendous progress has been made in building stronger laboratory infrastructure and training a qualified public health laboratory workforce across the country, allowing for decentralization of access to quality-assured services. Major achievements include development and implementation of a national laboratory strategic plan with a formalized and strengthened laboratory network; introduction of automation of testing to ensure better quality of results and diversify the menu of tests to effectively respond to outbreaks; expansion of molecular testing for tuberculosis, human immunodeficiency virus, malaria, diarrheal and respiratory diseases; establishment of laboratory-based surveillance of epidemic-prone diseases; and improvement of the overall quality of testing. Nonetheless, the progress and gains made remain fragile and require the full ownership and continuous investment from the Haitian government to sustain these successes and achievements.

Handheld solar light use, durability, and retention among women and girls in internally displaced persons camps in Haiti — 2013–2014

PubMed Central

Dynes, Michelle; Rosenthal, Mariana; Hulland, Erin; Hardy, Colleen; Torre, Lisandro; Tomczyk, Barbara

2016-01-01

During conflict and disasters, women and girls are at increased risk of gender based violence. International humanitarian guidelines call for the distribution of individual lighting to meet women and girls’ basic needs and to reduce risk of violence; however, little evidence exists to support these guidelines. This paper presents an evaluation of handheld solar light use, retention, and durability among women and girls living in two internally displaced persons camps in Port-au-Prince, Haiti. Data was gathered prospectively via five household surveys from August 2013 to April 2014; a total of 754 females participated in the study. Women reported going outside at night more frequently at the end of the study than at the beginning. The handheld solar lights were the most common source of lighting at endline, whereas candle and gas lamp use declined significantly over time. Results from a Life-Table survival analysis estimated that households had an 83% probability of still owning a functioning light after seven months. Given the frequent use, acceptable durability, and retention of the lights, donors and humanitarian organizations should consider supporting light distribution to women and girls in internally displaced persons camps to help meet their basic needs. PMID:27482509

Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti.

PubMed

Holm, Michelle R; Rudis, Maria I; Wilson, John W

2015-01-01

In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of 'real-time' medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

PubMed Central

Holm, Michelle R.; Rudis, Maria I.; Wilson, John W.

2015-01-01

Background In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. Design We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital. PMID:25623613

Haitian and international responders' and decision-makers' perspectives regarding disability and the response to the 2010 Haiti earthquake.

PubMed

Hunt, Matthew R; Chung, Ryoa; Durocher, Evelyne; Henrys, Jean Hugues

2015-01-01

Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disabilities experienced heightened vulnerability related to considerations including safety, access to services, and meeting basic needs. The objective of this research was to better understand the perceptions of responders and decision-makers regarding disability and efforts to address the needs of PWD following the 2010 earthquake. We conducted a qualitative study using interpretive description methodology and semistructured interviews with 14 Haitian and 10 international participants who were involved in the earthquake response. Participants identified PWD as being among the most vulnerable individuals following the earthquake. Though some forms of disability received considerable attention in aid efforts, the needs of other PWD did not. Several factors were identified as challenges for efforts to address the needs of PWD including lack of coordination and information sharing, the involvement of multiple aid sectors, perceptions that this should be the responsibility of specialized organizations, and the need to prioritize limited resources. Participants also reported shifts in local social views related to disability following the earthquake. Addressing the needs of PWD following a disaster is a crucial population health challenge and raises questions related to equity and responsibility for non-governmental organizations, governments, and local communities.

Disaster preparedness and response improvement: comparison of the 2010 Haiti earthquake-related diagnoses with baseline medical data.

PubMed

van Berlaer, Gerlant; Staes, Tom; Danschutter, Dirk; Ackermans, Ronald; Zannini, Stefano; Rossi, Gabriele; Buyl, Ronald; Gijs, Geert; Debacker, Michel; Hubloue, Ives

2017-10-01

Disaster medicine research generally lacks control groups. This study aims to describe categories of diagnoses encountered by the Belgian First Aid and Support Team after the 2010 Haiti earthquake and extract earthquake-related changes from comparison with comparable baseline data. The hypothesis is that besides earthquake-related trauma, medical problems emerge soon, questioning an appropriate composition of Foreign Medical Teams and Interagency Emergency Health Kits. Using a descriptive cohort study design, diagnoses of patients presenting to the Belgian field hospital were prospectively registered during 4 weeks after the earthquake and compared with those recorded similarly by Médecins Sans Frontières in the same area and time span in previous and later years. Of 7000 triaged postearthquake patients, 3500 were admitted, of whom 2795 were included and analysed. In the fortnight after the earthquake, 90% suffered from injury. In the following fortnight, medical diseases emerged, particularly respiratory (23%) and digestive (14%). More than 53% developed infections within 3 weeks after the event. Médecins Sans Frontières registered 6407 patients in 2009; 6033 in 2011; and 7300 in 2012. A comparison indicates that postearthquake patients suffered significantly less from violence, but more from wounds, respiratory, digestive and ophthalmological diseases. This is the first comparison of postearthquake diagnoses with baseline data. Within 2 weeks after the acute phase of an earthquake, respiratory, digestive and ophthalmological problems will emerge to the prejudice of trauma. This fact should be anticipated when composing Foreign Medical Teams and Interagency Emergency Health Kits to be sent to the disaster site.

76 FR 164 - Agency Information Collection Activities: Haitian Hemispheric Opportunity Through Partnership...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-03

... (``Haiti HOPE'') Act of 2006. This is a proposed extension of an information collection that was previously... Encouragement (``Haiti HOPE'') Act of 2006. OMB Number: 1651-0129. Abstract: Title V of the Tax Relief and... Hemispheric Opportunity through Partnership Encouragement Act of 2006 (``Haiti HOPE Act''), provides for duty...

75 FR 26344 - Temporary Exclusion of the Assessment of Overflight Fees for Humanitarian Flights Related to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... of Overflight Fees for Humanitarian Flights Related to the January 12, 2010, Earthquake in Haiti... the assessment of Overflight Fees for humanitarian flights in response to the earthquake in Haiti. SUMMARY: On January 12, 2010, the nation of Haiti was hit by a devastating earthquake near the heaviest...

75 FR 56120 - Employment Authorization for Haitian F-1 Nonimmigrant Students Experiencing Severe Economic...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-15

... January 12, 2010 Earthquake in Haiti AGENCY: U.S. Immigration and Customs Enforcement; DHS. ACTION: Notice..., 2010 earthquake in Haiti. The Department of Homeland Security (DHS) is taking action to provide relief... severe economic hardship as a direct result of the January 12, 2010 earthquake in Haiti. This notice...

Controlling Neglected Tropical Diseases (NTDs) in Haiti: Implementation Strategies and Evidence of Their Success

PubMed Central

Lemoine, Jean Frantz; Desormeaux, Anne Marie; Monestime, Franck; Fayette, Carl Renad; Desir, Luccene; Direny, Abdel Nasser; Carciunoiu, Sarah; Miller, Lior; Knipes, Alaine; Lammie, Patrick; Smith, Penelope; Stockton, Melissa; Trofimovich, Lily; Bhandari, Kalpana; Reithinger, Richard; Crowley, Kathryn; Ottesen, Eric; Baker, Margaret

2016-01-01

Lymphatic filariasis (LF) and soil-transmitted helminths (STH) have been targeted since 2000 in Haiti, with a strong mass drug administration (MDA) program led by the Ministry of Public Health and Population and its collaborating international partners. By 2012, Haiti’s neglected tropical disease (NTD) program had reached full national scale, and with such consistently good epidemiological coverage that it is now able to stop treatment for LF throughout almost all of the country. Essential to this success have been in the detail of how MDAs were implemented. These key programmatic elements included ensuring strong community awareness through an evidence-based, multi-channel communication and education campaign facilitated by voluntary drug distributors; strengthening community trust of the drug distributors by ensuring that respected community members were recruited and received appropriate training, supervision, identification, and motivation; enforcing a “directly observed treatment” strategy; providing easy access to treatment though numerous distribution posts and a strong drug supply chain; and ensuring quality data collection that was used to guide and inform MDA strategies. The evidence that these strategies were effective lies in both the high treatment coverage obtained– 100% geographical coverage reached in 2012, with almost all districts consistently achieving well above the epidemiological coverage targets of 65% for LF and 75% for STH—and the significant reduction in burden of infection– 45 communes having reached the target threshold for stopping treatment for LF. By taking advantage of sustained international financial and technical support, especially during the past eight years, Haiti’s very successful MDA campaign resulted in steady progress toward LF elimination and development of a strong foundation for ongoing STH control. These efforts, as described, have not only helped establish the global portfolio of “best practices” for

Mortality, violence and access to care in two districts of Port-au-Prince, Haiti

PubMed Central

Ponsar, Frédérique; Ford, Nathan; Van Herp, Michel; Mancini, Silvia; Bachy, Catherine

2009-01-01

Background Towards the end of 2006 open conflict broke out between United Nations forces and armed militia in Port-au-Prince, Haiti. Fighting was most intense in the district of Cité Soleil. Methods A cross-sectional, random-sample survey among the conflict-affected populations living in Cité Soleil and Martissant was carried out over a 4-week period in 2006 using a semi-structured questionnaire to assess exposure to violence and access to health care. Household heads from 945 households (corresponding to 4,763 people) in Cité Soleil and 1,800 household (9,539 people) in Martissant provided information on household members. The average recall period was 579 days for Cité Soleil and 601 days for Martissant. Results In Cité Soleil 120 deaths (21 children) were reported (CMR 0.4 deaths/10,000 people/day; <5 MR 0.5 deaths/10,000/day) while in Martissant 165 deaths (8 children) were reported (CMR 0.3/10,000 people/day; <5 MR 0.2/10,000 people/day). Violence was reported as the main cause of adult mortality in both locations (mainly gunshot wounds) accounting for 29.2% of deaths in Cité Soleil and 23% of deaths in Martissant. 22.9% of families in Cité Soleil and 18.6% in Martissant reported at least one victim of violence. Destruction of property and belongings was common in both Cité Soleil (52.4% of families) and Martissant (14.9%). Access to health services was limited, with 11% (22/196) of victims of violence in Cité Soleil and 23% (49/212) in Martissant unable to access care due to insecurity or lack of money. Discussion Extrapolating to the total population of these two districts some 2,000 violent deaths occurred over the recall period. Among the survivors, violence had lasting effects in terms of physical and mental health and loss of property and possessions. PMID:19317910

Depression, suicidal ideation, and associated factors: a cross-sectional study in rural Haiti

PubMed Central

2012-01-01

Background Since the 2010 earthquake in Haiti, there has been increased international attention to mental health needs throughout the country. The present study represents one of the first epidemiologic studies of depression symptomatology, suicidal ideation, and associated factors in Haiti’s Central Plateau. Methods We conducted a cross-sectional, zone-stratified household survey of 408 adults in Haiti’s Central Plateau. Depression symptomatology was assessed with a culturally-adapted Kreyòl version of the Beck Depression Inventory (BDI). Multivariable linear and logistic regression models were built using backward elimination, with the outcomes being continuous BDI scores and endorsing suicidal ideation, respectively. Results The mean BDI score was 20.4 (95% confidence interval [CI]: 19.3-21.5), and 6.13% (N = 25) of participants endorsed current suicidal ideation. Factors associated with BDI scores were: continuous age (adjusted beta [aβ]: 0.14, CI: 0.06-0.22), female gender (aβ: 2.1, CI: 0.18-4.0), suicidal ideation (aβ: 11.1, CI: 7.3-14.9), death in family (aβ: 2.7, CI: 0.57-4.9), and prior life-threatening illness (aβ: 2.6, CI: 0.77-4.5). Education was a risk factor for depression among women but not among men, and employment was a risk factor for both genders. Factors associated with endorsing suicidal ideation were: BDI score (ten point change) (adjusted odds ratio [aOR]: 2.5, CI: 1.7-3.6), lack of care if sick (aOR: 5.5, CI: 1.1-28.6), alcohol use (aOR: 3.3, CI: 1.3-8.2), and ever having been to a Vodou priest (aOR: 3.2, CI: 1.1-9.5). Conclusions A large proportion of Haiti’s Central Plateau may be experiencing high levels of depression symptomatology and/or current suicidal ideation. Screening could be conducted in biomedical, religious, and Vodou healing contexts. For prevention, poverty reduction and improved healthcare access are key elements. For treatment, general psychiatric services, psychosocial services for the medically ill and

Observations of Sprites above Haiti/Dominican Republic Thunderstorms from Arecibo Observatory, Puerto Rico

NASA Astrophysics Data System (ADS)

Pasko, V. P.; Stanley, M.; Mathews, J. D.; Inan, U. S.; Wood, T. G.; Cummer, S. A.; Williams, E. R.; Heavner, M. J.

2002-12-01

In August-September 2001 an experimental campaign has been conducted in Puerto Rico to perform correlative studies of lightning and lightning-induced ionospheric effects. The campaign, which was sponsored by a Small Grant for Exploratory Research from the National Science Foundation to Penn State University, had a broad range of scientific goals including studies ionospheric effects of thunderstorms, studies of VHF-quiet positive leaders and studies of large scale optical phenomena above ocean thunderstorms in tropics. As part of this program we conducted night time video recordings of lightning and large scale luminous phenomena above thunderstorms using a SONY DCR TRV 730 CCD video camera equipped with a blue extended ITT Night Vision GEN III NQ 6010 intensifier with 40 deg field of view. The intensifier provided a monochrome (predominantly green) image output. The video system was deployed at the Lidar Laboratory on the grounds of Arecibo Observatory, Puerto Rico (18.247 deg N, 66.754 deg W, elevation 305 m above the sea level). In this talk we report results of observations conducted between 01 and 03 UT on September 3, 2001. A total of 7 sprite events have been detected above a large thunderstorm system (cloud area exceeding 104 km2) located approximately 500 km from the observational site above Haiti/Dominican Republic. The observed events exhibited typical sprite features documented in other parts of the globe, including single columns, groups of columns, relatively small horizontal glows confined to higher altitudes, as well as two large and impulsive events with the transverse extent ~eq50 km. In this talk we will also report results of preliminary analysis of available ELF electromagnetic signatures associated with the observed events recorded by Stanford University at Palmer Station, Antarctica, Duke University, MIT and Los Alamos Sferic Array in Florida. Acknowledgments: The GEN III intensifier has been provided by ITT Night Vision Industries. We are

Education in the Wake of Natural Disaster

ERIC Educational Resources Information Center

Vallas, Paul

2014-01-01

In this essay, Paul Vallas--education reform expert and key advisor to the government of Haiti in developing its national education plan--discusses his plan for Haiti. The paper explores the successes and challenges of education reform in Haiti, before and after the earthquake that devastated the nation in 2010. The essay describes the…

19 CFR 10.844 - Value-content requirement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... assembled or knit-to-shape in Haiti and are entered during the initial applicable one-year period (except as... assembled or knit-to-shape in Haiti and are entered during the preceding applicable one-year period (except... calculation. The entry of an apparel article that is wholly assembled or knit-to-shape in Haiti and is...

Measuring the way forward in Haiti: grounding disaster relief in the legal framework of human rights.

PubMed

Klasing, Amanda M; Moses, P Scott; Satterthwaite, Margaret L

2011-07-14

This article provides results from an online survey of humanitarian workers and volunteers that was conducted in May and June 2010. The purpose of the survey was to understand how the humanitarian aid system adopts or incorporates human rights into its post-natural disaster work and metrics. Data collected from Haiti suggest that humanitarians have embraced a rights-based approach but that they do not agree about how this is defined or about what standards and indicators can be considered rights-based. This disagreement may reveal that humanitarians are aware of a mismatch between the rights-based approach to post-disaster humanitarian work and the legal framework of human rights. Using participation and accountability as examples, this article identifies and examines this mismatch and suggests that the humanitarian aid system should more fully embrace engagement with the human rights framework. To do so, the article concludes, humanitarian actors and the human rights community should have an open dialogue about the development of metrics that accurately reflect and monitor adherence to the legal framework of human rights. This would allow the humanitarian aid system to ensure its interventions enhance the capacity of the disaster-affected state to fulfill its human rights obligations, and would allow humanitarian and human rights actors alike to measure the impact of such interventions on the realization of human rights in post-natural disaster settings. Copyright © 2011 Klasing, Moses, and Satterthwaite. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

‘Life under the tent is not safe, especially for young women’: understanding intersectional violence among internally displaced youth in Leogane, Haiti

PubMed Central

Logie, Carmen H.; Daniel, CarolAnn; Ahmed, Uzma; Lash, Rebecca

2017-01-01

ABSTRACT Background: Haiti’s 2010 earthquake devastated social, health, and economic infrastructure and left 2 million persons homeless. Over 6 years later 61,000 people remain displaced, most lacking protection, services, and durable solutions. Structural contexts elevate risks of gender-based violence (GBV) targeting internally displaced (ID) girls and women. Objective: We used an intersectionality framework to explore lived experiences and understanding of violence among ID young men and women in Leogane, Haiti. Methods: We conducted six focus groups, three with ID young women (n = 30) and three with ID young men (n = 30) aged 18–24 years, and 11 in-depth individual interviews with frontline workers in Leogane. Focus groups and interviews were conducted in Kreyol, transcribed verbatim, translated into English, and analyzed using narrative thematic techniques. Results: Findings revealed violence experienced by ID youth was (re)produced at the intersection of gender, poverty, displacement, and age. Multi-level forms of violence included structural (e.g. poverty), community (e.g. gender norms, and interpersonal (e.g. family expectations) dimensions. Coping strategies spanned intrapersonal (hope), community (social support), and structural (employment/education) dimensions. Conclusions: Interventions to reduce violence should be tailored to address the social inequities that emerge at the intersection of youth, poverty, displacement, and hegemonic gender norms. PMID:28219254

Seroepidemiology of Toxoplasma in a coastal region of Haiti; Multiplex bead assay detection of immunoglobulin G antibodies that recognize the SAG2A antigen

PubMed Central

Priest, J. W.; Moss, D. M.; Arnold, B. F.; Hamlin, K.; Jones, C. C.; Lammie, P. J.

2018-01-01

Summary Toxoplasma gondii is a globally distributed parasitic protozoan that infects most warm blooded animals. We incorporated a bead coupled with recombinant SAG2A protein into our Neglected Tropical Disease (NTD) multiplex bead assay (MBA) panel and used it to determine Toxoplasma infection rates in two studies in Haiti. In a longitudinal cohort study of children 0–11 years old, the infection rate varied with age reaching a maximum of 0.131 infections/ year in children 3 years of age (95% CI = 0.065, 0.204). The median time to seroconversion was estimated to be 9.7 years (95% CI = 7.6, ∞). In a cross-sectional, community-wide survey of residents of all ages, we determined an overall seroprevalence of 28.2%. The seroprevalence age curve from the cross-sectional study also suggested that the force of infection varied with age and peaked at 0.057 infections/ year (95% CI = 0.033, 0.080) at 2.6 years of age. Integration of the Toxoplasma MBA into NTD surveys may allow for better estimates of the potential burden of congenital toxoplasmosis in underserved regions. PMID:25600668

Foreign field hospitals in the recent sudden-onset disasters in Iran, Haiti, Indonesia, and Pakistan.

PubMed

von Schreeb, Johan; Riddez, Louis; Samnegård, Hans; Rosling, Hans

2008-01-01

Foreign field hospitals (FFHs) may provide care for the injured and substitute for destroyed hospitals in the aftermath of sudden-onset disasters. In the aftermath of sudden-onset disasters, FFHs have been focused on providing emergency trauma care for the initial 48 hours following the sudden-onset disasters, while they tend to be operational much later. In addition, many have remained operational even later. The aim of this study was to assess the timing, activities, and capacities of the FFHs deployed after four recent sudden-onset disasters, and also to assess their adherence to the essential criteria for FFH deployment of the World Health Organization (WHO). Secondary information on the sudden-onset disasters in Bam, Iran in 2003, Haiti in 2004, Aceh, Indonesia in 2004, and Kashmir, Pakistan in 2005, including the number of FFHs deployed, their date of arrival, country of origin, length of stay, activities, and costs was retrieved by searching the Internet. Additional information was collected on-site in Iran, Indonesia, and Pakistan through direct observation and key informant interviews. Basic information was found for 43 FFHs in the four disasters. The first FFH was operational on Day 3 in Bam and Kashmir, and on Day 8 in Aceh. The first FFHs were all from the militaries of neighboring countries. The daily cost of a bed was estimated to be US$2,000. The bed occupancy rate generally was < 50%. None of the 43 FFHs met the first WHO/Pan-American Health Organization (PAHO) essential requirement if the aim is to provide emergency trauma care, while 15% followed the essential requirement if follow-up trauma and medical care is the aim of deployment. A striking finding was the lack of detailed information on FFH activities. None of the 43 FFHs arrived early enough to provide emergency medical trauma care. The deployment of FFHs following sudden-onset disasters should be better adapted to the main needs and the context and more oriented toward substituting for pre

[Socio-environmental vulnerability, disaster risk-reduction and resilience-building: lessons from the earthquake in Haiti and torrential rains in the mountain range close to Rio de Janeiro in Brazil].

PubMed

de Freitas, Carlos Machado; de Carvalho, Mauren Lopes; Ximenes, Elisa Francioli; Arraes, Eduardo Fonseca; Gomes, José Orlando

2012-06-01

Data on disasters around the world reveal greater seriousness in countries with lower social and economic development levels. In this context, disaster risk-reduction and resilience-building policies are priorities in the sustainable development agenda, featuring among the topics selected for the Rio+20 Summit. By means of a contribution of a conceptual nature and from examples of disasters in countries with different development levels, namely the Haiti earthquake and the torrential rains in the mountain range close to Rio de Janeiro in Brazil, the scope of this article is to demonstrate how socio-environmental vulnerability creates conditions for disasters, while at the same time limiting strategies for their prevention and mitigation. Lastly, some of the measures that disaster risk reduction and resilience-building demand in a socio-environmental vulnerability context are highlighted. These involve changes in the current patterns of social, economic and environmental development geared toward ecological sustainability and social justice as pillars of sustainable development.

Optimizing Household Chlorination Marketing Strategies: A Randomized Controlled Trial on the Effect of Price and Promotion on Adoption in Haiti.

PubMed

Ritter, Michael; Camille, Eveline; Velcine, Christophe; Guillaume, Rose-Kerline; Lantagne, Daniele

2017-07-01

Household water treatment can reduce diarrheal morbidity and mortality in developing countries, but adoption remains low and supply is often unreliable. To test effects of marketing strategies on consumers and suppliers, we randomized 1,798 households in rural Haiti and collected data on purchases of a household chlorination product for 4 months. Households received randomly selected prices ($0.11-$0.56 per chlorine bottle), and half received monthly visits from sales agents. Each $0.22 drop in price increased purchases by 0.10 bottles per household per month ( P < 0.001). At the mean price, each 1% drop in price increased purchases by 0.45% (elasticity = 0.45). There is suggestive evidence that household visits by some sales agents increased purchases at mid-range prices; however, the additional revenue did not offset visit cost. Choosing the lowest price and conducting visits maximizes chlorine purchase, whereas slightly raising the retail price and not conducting visits maximizes cost recovery. For the equivalent cost, price discounts increase purchases 4.2 times as much as adding visits at the current retail price. In this context, price subsidies may be a more cost-effective use of resources than household visits, though all marketing strategies tested offer cost-effective ways to achieve incremental health impact. Decisions about pricing and promotion for health products in developing countries affect health impact, cost recovery, and cost-effectiveness, and tradeoffs between these goals should be made explicit in program design.

Human rights abuse and other criminal violations in Port-au-Prince, Haiti: a random survey of households.

PubMed

Kolbe, Athena R; Hutson, Royce A

2006-09-02

Reliable evidence of the frequency and severity of human rights abuses in Haiti after the departure of the elected president in 2004 was scarce. We assessed data from a random survey of households in the greater Port-au-Prince area. Using random Global Positioning System (GPS) coordinate sampling, 1260 households (5720 individuals) were sampled. They were interviewed with a structured questionnaire by trained interviewers about their experiences after the departure of President Jean-Bertrand Aristide. The response rate was 90.7%. Information on demographic characteristics, crime, and human rights violations was obtained. Our findings suggested that 8000 individuals were murdered in the greater Port-au-Prince area during the 22-month period assessed. Almost half of the identified perpetrators were government forces or outside political actors. Sexual assault of women and girls was common, with findings suggesting that 35,000 women were victimised in the area; more than half of all female victims were younger than 18 years. Criminals were the most identified perpetrators, but officers from the Haitian National Police accounted for 13.8% and armed anti-Lavalas groups accounted for 10.6% of identified perpetrators of sexual assault. Kidnappings and extrajudicial detentions, physical assaults, death threats, physical threats, and threats of sexual violence were also common. Our results indicate that crime and systematic abuse of human rights were common in Port-au-Prince. Although criminals were the most identified perpetrators of violations, political actors and UN soldiers were also frequently identified. These findings suggest the need for a systematic response from the newly elected Haitian government, the UN, and social service organisations to address the legal, medical, psychological, and economic consequences of widespread human rights abuses and crime.

Evaluation of antibiotic self-medication among outpatients of the state university hospital of Port-Au-Prince, Haiti: a cross-sectional study.

PubMed

Moise, Kenny; Bernard, Joseph Junior; Henrys, Jean Hugues

2017-01-01

In Haiti, where all drugs are available over the counter, self-medication with antibiotics appears as a common practice. Inappropriate use of beta-lactams and macrolides is likely to contribute to the development of antimicrobial resistance. This study aimed to (i) assess the extent of self-medication with antibiotics, (ii) explore the contributing factors (age, gender and educational background) and (iii) identify specific antibiotic drug classes used among patients attending the outpatient clinic of the State University Hospital of Port-au-Prince. A cross-sectional survey among 200 outpatients of the State University Hospital of Port-au-Prince was conducted in December 2014. Face-to-face interviews were conducted using a standardized questionnaire. Parents of pediatric patients were allowed to answer to questions on their behalf. Among the study sample, 45.5% practiced self-medication with antibiotics. It was less prevalent among patients with the highest education level (23.1%; OR: 0.89 (0.5-1.75), p = 0.001). Mild symptoms (28.6%) and vaginal itching (44.4%) were the main reasons for self-medication with antibiotics. Self-medication using amoxicillin was reported by 67.0%. Self-medication with antibiotics is a common practice among Haitian patients and is more common among the less educated. Amoxicillin for urinary tract infections is the most commonly used medication. It is crucial to raise awareness on the dangers of the practice in the population and inforce the current law regarding the use of over the counter antibiotics.

3 CFR 8478 - Proclamation 8478 of February 24, 2010. American Red Cross Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... Africa, to saving lives after the tragic earthquake in Haiti, the American people have an unmatched... contributing to humanitarian efforts worldwide. This year’s catastrophic earthquake in Haiti caused untold...

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

Low prevalence of Vibrio cholerae O1 versus moderate prevalence of intestinal parasites in food-handlers working with health care personnel in Haiti.

PubMed

Llanes, Rafael; Somarriba, Lorenzo; Velázquez, Beltran; Núñez, Fidel A; Villafranca, Caridad M

2016-01-01

Food-handlers with poor personal hygiene working in food-service establishments could be potential sources of infection due to pathogenic organisms. In May 2011, a cross-sectional study was undertaken to determine the prevalence of bacteria and intestinal parasites among food-handlers working with Cuban health personnel in Haiti. Stool specimens were collected from 56 food-handlers and samples were examined using standard procedures. Of the food handlers, 26.8% had one bacterial or intestinal parasite. The most prevalent species of organism found were Blastocystis spp. (9%), followed by Vibrio cholerae O1 serotype Ogawa, Aeromonas spp. and Giardia intestinalis, each one with 4%. The prevalence of intestinal parasites was 19.7%. Five out of 56 food handlers had diarrhea at the time the study was conducted. It was found that there was a lower prevalence of V. cholerae O1 serotype Ogawa in comparison to intestinal parasites. The study highlights the importance of the precautions that must be taken in cholera-affected countries by medical teams and their organizations, with emphasis on the preparation, processing, and serving of meals. The recommendation is to intensify continuing education programs, periodical laboratory examinations to detect carriers and food-handlers reporting sick, and to observe strict adherence to hygienic food-handling practices. In addition, food handlers with diarrhea should refrain from preparation or delivery of food.

Pediatric surgical capacity building - a pathway to improving access to pediatric surgical care in Haiti.

PubMed

Kaseje, Neema; Jenny, Hillary; Jeudy, Andre Patrick; MacLee, Jean Louis; Meara, John G; Ford, Henri R

2018-02-01

Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures. We conducted baseline and post-intervention knowledge exams and dedicated 1 day a week to teaching and research activities. We measured the following outcomes: number of residents that completed the rotation, mean pre and post intervention test scores, patient volume in clinic and operating room, postoperative outcomes, resident ability to perform most common elective and emergent procedures, and resident participation in research. Nine out of 9 residents completed the rotation; 987 patients were seen in outpatient clinic, and 564 procedures were performed in children <15years old. There was a 50% increase in volume of pediatric cases and a 100% increase in procedures performed in children <4years old. Postoperative outcomes were: 0% mortality for elective cases and 18% mortality for emergent cases, 3% complication rate for elective cases and 6% complication rate for emergent cases. Outcomes did not change with increased responsibility given to residents. All senior residents (n=4) could perform the most common elective and emergent procedures without changes in mortality and complication rates. Increases in mean pre and post intervention test scores were 12% (PGY1), 24% (PGY2), and 10% (PGY3). 75% of senior residents participated in research activities as first or second authors. Establishing a program in pediatric surgery with capacity building

Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings.

PubMed

Eustache, Eddy; Gerbasi, Margaret E; Severe, Jennifer; Fils-Aimé, J Reginald; Smith Fawzi, Mary C; Raviola, Giuseppe J; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J; Becker, Anne E

2017-06-01

Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. To assess feasibility, acceptability and utility of the teacher accompaniment phase of a school-based Teacher- Accompagnateur Pilot Study (TAPS) in Haiti. We assigned student participants, aged 18-22 years ( n = 120), to teacher participants ( n = 22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction and utility by the percentage with identified mental health need who discussed treatment with a teacher. Favorable ratings support feasibility, acceptability and utility of teacher- accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings.

After the flood: an evaluation of in-home drinking water treatment with combined flocculent-disinfectant following Tropical Storm Jeanne -- Gonaives, Haiti, 2004.

PubMed

Colindres, Romulo E; Jain, Seema; Bowen, Anna; Mintz, Eric; Domond, Polyana

2007-09-01

Tropical Storm Jeanne struck Haiti in September 2004, causing widespread flooding which contaminated water sources, displaced thousands of families and killed approximately 2,800 people. Local leaders distributed PūR, a flocculent-disinfectant product for household water treatment, to affected populations. We evaluated knowledge, attitudes, practices, and drinking water quality among a sample of PūR recipients. We interviewed representatives of 100 households in three rural communities who received PūR and PūR-related education. Water sources were tested for fecal contamination and turbidity; stored household water was tested for residual chlorine. All households relied on untreated water sources (springs [66%], wells [15%], community taps [13%], and rivers [6%]). After distribution, PūR was the most common in-home treatment method (58%) followed by chlorination (30%), plant-based flocculation (6%), boiling (5%), and filtration (1%). Seventy-eight percent of respondents correctly answered five questions about how to use PūR; 81% reported PūR easy to use; and 97% reported that PūR-treated water appears, tastes, and smells better than untreated water. Although water sources tested appeared clear, fecal coliform bacteria were detected in all sources (range 1 - >200 cfu/100 ml). Chlorine was present in 10 (45%) of 22 stored drinking water samples in households using PūR. PūR was well-accepted and properly used in remote communities where local leaders helped with distribution and education. This highly effective water purification method can help protect disaster-affected communities from waterborne disease.

Hispaniola

NASA Image and Video Library

2010-01-14

This image, produced from instrument data aboard NASA Space Shuttle Endeavour, is a perspective view of the topography of Port-au-Prince, Haiti and Hispianola. A magnitude 7.0 earthquake occurred on Haiti on January 12, 2010.

Using a Full Complex Site Transfer Function to Estimate Strong Ground Motion in Port-au-Prince (Haiti).

NASA Astrophysics Data System (ADS)

ST Fleur, S.; Courboulex, F.; Bertrand, E.; Mercier De Lepinay, B. F.; Hough, S. E.; Boisson, D.; Momplaisir, R.

2017-12-01

To assess the possible impact of a future earthquake in the urban area of Port-au-Prince (Haiti), we have implemented a simulation approach for complex ground motions produced by an earthquake. To this end, we have integrated local site effect in the prediction of strong ground motions in Port-au-Prince using the complex transfer functions method, which takes into account amplitude changes as well as phase changes. This technique is particularly suitable for basins where a conventional 1D digital approach proves inadequate, as is the case in Port-au-Prince. To do this, we use the results of the Standard Spectral Ratio (SSR) approach of St Fleur et al. (2016) to estimate the amplitude of the response of the site to a nearby rock site. Then, we determine the phase difference between sites, interpreted as changes in the phase of the signal related to local site conditions, using the signals of the 2010 earthquake aftershocks records. Finally, the accelerogram of the simulated earthquake is obtain using the technique of the inverse Fourier transform. The results of this study showed that the strongest soil motions are expected in neighborhoods of downtown Port-au-Prince and adjacent hills. In addition, this simulation method by complex transfer functions was validated by comparison with recorded actual data. Our simulated response spectra reproduce very well both the amplitude and the shape of the response spectra of recorded earthquakes. This new approach allowed to reproduce the lengthening of the signal that could be generated by surface waves at certain stations in the city of Port-au-Prince. However, two points of vigilance must be considered: (1) a good signal-to-noise ratio is necessary to obtain a robust estimate of the site-reference phase shift (ratio at least equal to 10); (2) unless the amplitude and phase changes are measured on strong motion records, this technique does not take non-linear effects into account.

Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania

PubMed Central

Winter, Rebecca; Yourkavitch, Jennifer; Wang, Wenjuan; Mallick, Lindsay

2017-01-01

Background Despite the importance of health facility capacity to provide comprehensive care, the most widely used indicators for global monitoring of maternal and child health remain contact measures which assess women’s use of services only and not the capacity of health facilities to provide those services; there is a gap in monitoring health facilities’ capacity to provide newborn care services in low and middle income countries. Methods In this study we demonstrate a measurable framework for assessing health facility capacity to provide newborn care using open access, nationally–representative Service Provision Assessment (SPA) data from the Demographic Health Surveys Program. In particular, we examine whether key newborn–related services are available at the facility (ie, service availability, measured by the availability of basic emergency obstetric care (BEmOC) signal functions, newborn signal functions, and routine perinatal services), and whether the facility has the equipment, medications, training and knowledge necessary to provide those services (ie, service readiness, measured by general facility requirements, equipment, medicines and commodities, and guidelines and staffing) in five countries with high levels of neonatal mortality and recent SPA data: Bangladesh, Haiti, Malawi, Senegal, and Tanzania. Findings In each country, we find that key services and commodities needed for comprehensive delivery and newborn care are missing from a large percentage of facilities with delivery services. Of three domains of service availability examined, scores for routine care availability are highest, while scores for newborn signal function availability are lowest. Of four domains of service readiness examined, scores for general requirements and equipment are highest, while scores for guidelines and staffing are lowest. Conclusions Both service availability and readiness tend to be highest in hospitals and facilities in urban areas, pointing to

77 FR 28393 - Disease, Disability, and Injury Prevention and Control Special Emphasis Panel (SEP): Initial Review

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... Support Post Earthquake Reconstruction, Cholera and HIV/AIDS Response, FOA GH12-001, and Research and Technical Assistance for Public Health Laboratories in Haiti to Support Post Earthquake Reconstruction... and Technical Assistance for Public Health Interventions in Haiti to Support Post Earthquake...

Formative research on a teacher accompaniment model to promote youth mental health in Haiti: Relevance to mental health task-sharing in low-resource school settings

PubMed Central

Eustache, Eddy; Gerbasi, Margaret E.; Severe, Jennifer; Fils-Aimé, J. Reginald; Smith Fawzi, Mary C.; Raviola, Giuseppe J.; Darghouth, Sarah; Boyd, Kate; Thérosmé, Tatiana; Legha, Rupinder; Pierre, Ermaze L.; Affricot, Emmeline; Alcindor, Yoldie; Grelotti, David J.; Becker, Anne E.

2017-01-01

Background Task-sharing with teachers to promote youth mental health is a promising but underdeveloped strategy in improving care access in low-income countries. Aims To assess feasibility, acceptability, and utility of the teacher accompaniment phase of a school-based teacher accompagnateur pilot study (TAPS) in Haiti. Methods We assigned student participants, ages 18–22 (n=120) to a teacher participant (n=22) within four Haitian schools; we instructed participants to arrange meetings with their assigned counterparts to discuss mental health treatment, academic skills, and/or well-being. We measured student and teacher perceived feasibility, acceptability, and utility of meetings with self-report Likert-style questions. We examined overall program feasibility by the percentage of students with a documented meeting, acceptability by a composite measure of student satisfaction, and utility by the percentage with identified mental health need who discussed treatment with a teacher. Results Favorable ratings support feasibility, acceptability, and utility of teacher-accompagnateur meetings with students. The majority of students (54%) met with a teacher. Among students with an identified mental disorder, 43.2% discussed treatment during a meeting. Conclusions This accompaniment approach to mental health task-sharing with teachers provided a school-based opportunity for students with mental health need to discuss treatment and has potential relevance to other low-income settings. PMID:28367718

Pathfinder. Volume 8, Number 2, March/April 2010

DTIC Science & Technology

2010-04-01

the Haiti Crisis Action Team ( CAT ) to coordinate the around-the- clock GEOINT response with NGA’s mission partners. Practicing the collaborative...The leader of the Haiti CAT , as the Americas NSG Operations Executive, enlisted the full gamut of available GEOINT. Employing UGO allowed decision

Little by Little the Bird Builds Its Nest: First Steps in Cross Cultural Curriculum Training

ERIC Educational Resources Information Center

Harte, Helene Arbouet; Jones, Melissa M.; Wray, Francis

2015-01-01

With the goal of raising awareness of child slavery and devastation of the natural environment in Haiti, while simultaneously supporting active teaching strategies, a team of educators collaborated to develop The Respecting Haiti curriculum. Following development of the curriculum, representatives from the team facilitated curriculum training with…

76 FR 28997 - Extension of Employment Authorization for Haitian F-1 Nonimmigrant Students Experiencing Severe...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-19

... Direct Result of the January 12, 2010 Earthquake in Haiti AGENCY: U.S. Immigration and Customs... earthquake in Haiti. This notice extends the effective date of that notice. DATES: This notice is effective... who are experiencing severe economic hardship as a direct result of the January 12, 2010 earthquake in...

77 FR 59942 - Extension of Employment Authorization for Haitian F-1 Nonimmigrant Students Experiencing Severe...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... Direct Result of the January 12, 2010 Earthquake in Haiti AGENCY: U.S. Immigration and Customs... earthquake in Haiti. This notice extends the effective date of that notice. DATES: This notice is effective... who are experiencing severe economic hardship as a direct result of the January 12, 2010 earthquake in...

Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

PubMed

Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

2014-01-01

Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P < 0.001). The effects were sustained 6 mo postintervention. Morbidity and developmental outcomes did not differ by trial arm. A low-energy, fortified product improved the linear growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.